What is Candidiasis?

Candidiasis, commonly known as a yeast infection, is a fungal infection caused by any type of Candida yeasts, most commonly Candida albicans. Candida typically lives on and in the body harmlessly, but sometimes it can overgrow and cause an infection, especially in moist, warm areas of the body where there are small amounts of moisture.

Types of Infections

There are several types depending on where in the body the infection occurs:

Oral

The mouth and throat are common sites for oral Candidiasis infections, which can cause problems like creamy white lesions on the inner cheeks or tongue (thrush). Oral thrush is common in babies and the elderly or anyone with a weakened immune system. Risk factors include taking antibiotics, cancer treatment, diabetes, or dentures. Symptoms include white patches on the inner cheeks or tongue that can sometimes be wiped off, leaving a red, sore surface underneath.

Vaginal

Most women will experience at least one vaginal yeast infection in their lifetime caused by Candida overgrowth in the vagina. Vaginal (also known as a yeast infection) causes irritation, discharge and intense itching of the vulva and vagina. Symptoms include thick, white discharge that looks like cottage cheese clumps, intense itching, redness and swelling of the vulva. This type of infection is very common during pregnancy or in those with health issues like diabetes. Risk factors include antibiotic use, pregnancy, and high-sugar diets.

Cutaneous

The skin is another area Candida can infect, causing cutaneous. This ranges from mild to severe forms including cradidial intertrigo (skin folds), paronychia (around the nails) and chronic mucocutaneous candidiasis. Skin manifestations vary but often cause painful, itchy red rashes or lesions, especially in skin folds. Risk increases in those with weakened immune systems.

Systemic

For people with severely compromised immune systems, a rare but serious form called systemic or invasive candidiasis may develop if the infection spreads beyond superficial sites into the bloodstream and internal organs. This requires emergency treatment. Those at high risk include AIDS/HIV patients, people on prolonged antibiotic treatment or with cancer or organ transplants. Symptoms vary depending on infected area but may include fever and organ dysfunction.

Diagnosis and Testing

Doctors can usually diagnose common infections based on symptoms and location of lesions or rashes. For more complicated cases, tests may include microscopy of skin scrapings, urine or blood samples to look for yeast cells and cultures to identify the exact Candida species. Blood tests can detect antigens produced by the yeast. Endoscopy or biopsy of affected sites may also be done in severe infections.

Treatment and Prevention

Most infections clear up quickly with over-the-counter antifungal creams, ointments or suppositories applied directly to the infected area. For stubborn or recurrent infections, oral antifungal medications like fluconazole may be prescribed for 7-14 days. Those with HIV/AIDS or other risk factors may need lifelong antifungal suppressive therapy. General prevention strategies include keeping skin dry, wearing loose cotton clothing, practicing good hygiene, treating other infections promptly and eating a healthy diet low in sugars and simple carbs.

Recurrence and Chronic Candidiasis

Even with prompt treatment, some people experience frequent recurrences of infections like vaginal . This may point to an underlying problem like an impaired immune system or biochemical imbalance favoring yeast overgrowth. Chronic mucocutaneous usually indicates a primary immunodeficiency and requires immunotherapy or antifungal medication long-term. Women concerned about recurrent infections should discuss strategies like maintenance antifungal therapy with their doctor.

Who is at risk?

Anyone can develop a infection, but certain groups are at higher risk. Those with weakened immunity from health issues, medications or lifestyle factors have a harder time keeping Candida in check. Risk is highest in people with AIDS/HIV, cancer, diabetes, autoimmune disorders, organ transplants, prolonged antibiotic or corticosteroid use, and very young or elderly individuals. Other factors like high-sugar diets, obesity, pregnancy, and tight-fitting clothes that retain heat and moisture can also encourage overgrowth. Understanding risk factors is important for prevention and early detection.

The growing problem of antifungal resistance

With the rise in use of antifungal medications, some Candida strains have developed resistance to common drugs like fluconazole. This is an emerging problem, as fewer antifungal options are available compared to antibiotics. Resistance often stems from long-term suppressive therapy, non-adherence to treatment guidance like full course completion, or exposure through environmental sources. Those on long-term azole drugs must be monitored for resistance. New antifungal classes in development aim to overcome resistance and fill gaps, but prevention through lifestyle changes remains the best long-term strategy.

It is a common yeast infection that affects different areas of the body in both acute and chronic forms. Anyone can develop candidiasis, but those with impaired immunity or certain risk factors are more vulnerable. Doctors can diagnose based on symptoms and confirm with testing as needed. Most cases clear up quickly with over-the-counter or prescription antifungals. But recurrent or chronic infections may indicate an underlying problem requiring ongoing management. Prevention focuses on controlling risk factors, treating other infections promptly and limiting recurrences.

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