Candidiasis

Candidiasis
Other namesCandidosis, moniliasis, oidiomycosis [1]
Photo of a light-skinned human sticking tongue out where the tongue is mostly colored light yellow due to an oral candidiasis infection
Oral candidiasis (thrush)
SpecialtyInfectious disease
SymptomsWhite patches or vaginal discharge, itching [2][3]
CausesCandida (a type of yeast)[4]
Risk factorsImmunosuppression (HIV/AIDS), diabetes, corticosteroids, antibiotic therapy [5]
MedicationClotrimazole, nystatin, fluconazole[6]
Frequency6% of babies (mouth)[7] 75% of women at some time (vaginal)[8]

Candidiasis is a fungal infection due to any species of the genus Candida (a yeast).[4] When it affects the mouth, in some countries it is commonly called thrush.[3] Signs and symptoms include white patches on the tongue or other areas of the mouth and throat.[3] Other symptoms may include soreness and problems swallowing.[9] When it affects the vagina, it may be referred to as a yeast infection or thrush.[2][10] Signs and symptoms include genital itching, burning, and sometimes a white "cottage cheese-like" discharge from the vagina.[11] Yeast infections of the penis are less common and typically present with an itchy rash.[11] Very rarely, yeast infections may become invasive, spreading to other parts of the body.[12] This may result in fevers, among other symptoms.[12]

More than 20 types of Candida may cause infection with Candida albicans being the most common.[13] Infections of the mouth are most common among children less than one month old, the elderly, and those with weak immune systems.[5] Conditions that result in a weak immune system include HIV/AIDS, the medications used after organ transplantation, diabetes, and the use of corticosteroids.[5] Other risk factors include during breastfeeding, following antibiotic therapy, and the wearing of dentures.[5][14] Vaginal infections occur more commonly during pregnancy, in those with weak immune systems, and following antibiotic therapy.[15] Individuals at risk for invasive candidiasis include low birth weight babies, people recovering from surgery, people admitted to intensive care units, and those with an otherwise compromised immune system.[16]

Efforts to prevent infections of the mouth include the use of chlorhexidine mouthwash in those with poor immune function and washing out the mouth following the use of inhaled steroids.[6] Little evidence supports probiotics for either prevention or treatment, even among those with frequent vaginal infections.[17][18] For infections of the mouth, treatment with topical clotrimazole or nystatin is usually effective.[6] Oral or intravenous fluconazole, itraconazole, or amphotericin B may be used if these do not work.[6] A number of topical antifungal medications may be used for vaginal infections, including clotrimazole.[19] In those with widespread disease, an echinocandin such as caspofungin or micafungin is used.[20] A number of weeks of intravenous amphotericin B may be used as an alternative.[20] In certain groups at very high risk, antifungal medications may be used preventively,[16][20] and concomitantly with medications known to precipitate infections.

Infections of the mouth occur in about 6% of babies less than a month old.[7] About 20% of those receiving chemotherapy for cancer and 20% of those with AIDS also develop the disease.[7] About three-quarters of women have at least one yeast infection at some time during their lives.[8] Widespread disease is rare except in those who have risk factors.[21]

  1. ^ Cite error: The named reference Andrews was invoked but never defined (see the help page).
  2. ^ a b "Vaginal Candidiasis". Fungal Diseases. United States: Centers for Disease Control and Prevention. 13 November 2019. Archived from the original on 29 December 2014. Retrieved 24 Dec 2019.
  3. ^ a b c "Candida infections of the mouth, throat, and esophagus". Fungal Diseases. United States: Centers for Disease Control and Prevention. 13 November 2019. Archived from the original on 9 January 2019. Retrieved 24 Dec 2019.
  4. ^ a b "Candidiasis". Fungal Diseases. United States: Centers for Disease Control and Prevention. 13 November 2019. Archived from the original on 29 December 2014. Retrieved 24 Dec 2019.
  5. ^ a b c d "Risk & Prevention". cdc.gov. February 13, 2014. Archived from the original on 29 December 2014. Retrieved 28 December 2014.
  6. ^ a b c d "Treatment & Outcomes of Oral Candidiasis". cdc.gov. February 13, 2014. Archived from the original on 29 December 2014. Retrieved 28 December 2014.
  7. ^ a b c "Oral Candidiasis Statistics". cdc.gov. February 13, 2014. Archived from the original on 29 December 2014. Retrieved 28 December 2014.
  8. ^ a b "Genital / vulvovaginal candidiasis (VVC)". cdc.gov. February 13, 2014. Archived from the original on 29 December 2014. Retrieved 28 December 2014.
  9. ^ "Symptoms of Oral Candidiasis". cdc.gov. February 13, 2014. Archived from the original on 29 December 2014. Retrieved 28 December 2014.
  10. ^ "Thrush in men and women". nhs.uk. 9 January 2018. Archived from the original on 25 September 2018. Retrieved 16 March 2020.
  11. ^ a b "Symptoms of Genital / Vulvovaginal Candidiasis". cdc.gov. February 13, 2014. Archived from the original on 29 December 2014. Retrieved 28 December 2014.
  12. ^ a b "Symptoms of Invasive Candidiasis". cdc.gov. February 13, 2014. Archived from the original on 29 December 2014. Retrieved 28 December 2014.
  13. ^ "Candidiasis". cdc.gov. February 13, 2014. Archived from the original on 29 December 2014. Retrieved 28 December 2014.
  14. ^ Walker M (2008). "Conquering common breast-feeding problems". The Journal of Perinatal & Neonatal Nursing. 22 (4): 267–74. doi:10.1097/01.JPN.0000341356.45446.23. PMID 19011490. S2CID 27801867.
  15. ^ "People at Risk for Genital / Vulvovaginal Candidiasis". cdc.gov. February 13, 2014. Archived from the original on 29 December 2014. Retrieved 28 December 2014.
  16. ^ a b "People at Risk for Invasive Candidiasis". cdc.gov. February 13, 2014. Archived from the original on 29 December 2014. Retrieved 28 December 2014.
  17. ^ Jurden L, Buchanan M, Kelsberg G, Safranek S (June 2012). "Clinical inquiries. Can probiotics safely prevent recurrent vaginitis?". The Journal of Family Practice. 61 (6): 357, 368. PMID 22670239.
  18. ^ Abad CL, Safdar N (June 2009). "The role of lactobacillus probiotics in the treatment or prevention of urogenital infections--a systematic review". Journal of Chemotherapy. 21 (3): 243–52. doi:10.1179/joc.2009.21.3.243. PMID 19567343. S2CID 32398416.
  19. ^ "Treatment & Outcomes of Genital / Vulvovaginal Candidiasis". cdc.gov. February 13, 2014. Archived from the original on 29 December 2014. Retrieved 28 December 2014.
  20. ^ a b c Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, et al. (February 2016). "Executive Summary: Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America". Clinical Infectious Diseases. 62 (4): 409–17. doi:10.1093/cid/civ1194. PMID 26810419.
  21. ^ "Invasive Candidiasis Statistics". cdc.gov. February 13, 2014. Archived from the original on 29 December 2014. Retrieved 28 December 2014.