Candidiasis (yeast infections, oral thrush)

Candidiasis is an infection caused by a yeast called Candida albicans. Candida is normally found in virtually all normal people but causes problems and infections in only small cases. We are seeing candidiasis more frequently now due to overuse of antibiotics, increase in incidence of AIDS, and use of organ transplantations, and devices like catheters, artificial valves and joints, all of which increase infection risks. Candidiasis can cause infections of vaginal canal, mouth, deep organs, and sometimes widespread infection of the bloodstream. It is also the yeast infection that causes diaper rashes in babies.

Vaginal candidiasis

This is a common cause of vaginal infections in women, affecting one million women annually

 

What causes it?

Vaginal canal naturally contains a balanced mix of yeast, including candida, and bacteria. Lactobacillus, a bacterial species found in dairy, prevents overgrowth of yeast. This balance is disrupted from antibiotic use, which cause bacterial and yeast imbalance, in states of increased estrogen as in pregnancy and during use of oral contraceptives and hormone therapy, in individuals with poorly controlled diabetes, and in those with weakened immune system. 

This is a common cause of vaginal infections in women, affecting one million women annually

What are the symptoms?

It is a very common vaginal yeast infection that affects up to 75% of all women at some point in their lifetime. It presents with white, thick, odor-free vaginal discharge with cottage-cheese appearance. It causes swelling, irritation, pain, soreness, watery vaginal discharge and intense itchiness of the vagina and the vulva. Some may experience a burning sensation during urination and intercourse. A vaginal yeast infection is not a sexually transmitted disease, but there is increased risk of acquiring it during initial regular sexual activity.  Some infections may be due to to mouth to genital contact (oral-genital sex).

 

What is the treatment?

Treatment of yeast infections is aimed at killing the yeast that is causing the infections. Usually, over the counter medications like creams, suppositories and tablets that are inserted into the vagina or applied on the vulva.  Your doctor can also prescribe a pill that you swallow or with medicines that you put in the vagina and on the vulva. 

For complicated yeast infections that present with four or more episodes within a year, with severe signs and symptoms causing cracks and sores, infections in pregnant females or in individuals with poorly controlled diabetes, weakened immune system from medications or other diseases and infections, a longer treatment course may be needed.

Oral candidiasis

This disorder, also known as oral thrush, causes white, curd-like patches in the mouth or throat. The patches can also appear on the tongue, inside of the cheeks, or the palate. For patients who wear dentures, they will experience redness without white patches. Most patients feel that their mouth feels like it is filled with cotton. Oral candidiasis typically occurs in people with abnormal immune systems, patients undergoing chemotherapy for cancer, people taking immunosuppressive drugs to protect transplanted organs, people with HIV infection, or patients taking certain medications through their mouth like inhalers as part of their respiratory therapy. 

People with thrush usually get a prescription mouth rinse, a medicated lozenge, a tablet to stick inside your gums, to kill the yeast. Your doctor may sometimes prescribe a pill, especially if you have severe symptoms, have diabetes or weakened immune system or you are at risk for severe infections. 

To prevent thrush, it is important to keep your mouth clean. Insides of mouth and tongue should be brushed as a part of your daily routine. If you take inhalers by mouth, you should rinse the mouth after each use. If you wear dentures, it is really important to clean them nightly and to give your mouth some denture-free time.

Deep organ candidiasis

It is also known as invasive candidiasis, and it is a serious systemic infection that can affect internal organs like esophagus, heart, blood, liver, spleen, kidneys, eyes, and skin. It may start out as normal skin colonization or even vaginal and oral candidiasis, but being an opportunistic disease, it can spread when a patient's immune system is lowered, often due to medications or another illnesses. It is also seen in patients with history of stomach surgeries, burns, nasogastric tubes and catheters because they can interfere with body's natural defense against infections including candidiasis. Increased incidence of candidiasis is also seen in patients with AIDS, organ transplant recipients, patients with weakened immune systems, and in patients with decreased, malfunctioning or missing white blood cells. Treatment in these patients starts with removal of any foreign devices likes catheters and systemic antifungal treatments to prevent spread of disease. For prevention, it is important to keep catheters clean and for as short a time as possible.

Talk to your dermatologist for candida infections that are not responding to over the counter treatment options or if you have diabetes, weakened immune system from medical conditions, AIDS or from medications, are pregnant, or have devices like catheters and tubes.