Candidiasis Yeast Infection Overview
A yeast infection results from an overgrowth of yeast (a type of fungus) anywhere in the body. Candidiasis is by far the most common type of yeast infection. There are more than 20 species of Candida, the most common being Candida albicans. These fungi live on all surfaces of our bodies. Under certain conditions, they can become so numerous they cause infections, particularly in warm and moist areas. Examples of such infections are vaginal yeast infections, thrush (infection of tissues of the oral cavity), skin and diaper rash, and nailbed infections.
Candidal infections commonly occur in warm moist body areas, such as underarms. Usually your skin effectively blocks yeast, but any breakdown or cuts in the skin may allow this organism to penetrate.
Typical affected areas in babies include the mouth and diaper areas.
Vaginal yeast infection, which is the most common form of vaginitis is often referred to as vaginal Candidiasis.
In adults, oral yeast infections become more common with increased age. Adults also can have yeast infections around dentures, in skin folds under the breast and lower abdomen, nailbeds, and beneath other skin folds. Most of these candidal infections are superficial and clear up easily with treatment. Infections of the nailbeds often require prolonged therapy.
Rarely, the yeast infection may spread throughout the body. In systemic candidal disease (in which the fungus enters the bloodstream and spreads throughout the body), up to 45% of people may die. Even common mouth and vaginal yeast infections can cause critical illness and can be more resistant to normal treatment.
Yeast infections that return may be a sign of more serious diseases such as diabetes, leukemia, or AIDS.
Candidiasis Yeast Infection Causes
In women, yeast infections are the second most common reason for vaginal burning, itching, and discharge. Yeasts are found in the vagina of 20% to 50% of healthy women and can overgrow if the environment in the vagina changes. Antibiotic and steroid use is the most common reason for yeast overgrowth. But pregnancy, menstruation, sperm, diabetes, and birth control pills also can contribute to getting a yeast infection. Yeast infections are more common after menopause
In people who have a weakened immune system because of cancer treatments, steroids, or diseases such as AIDS, candidal infections can occur throughout the entire body and can be life-threatening. The blood, brain, eye, kidney, and heart are most frequently affected, but Candida also can grow in the lungs, liver, and spleen. Candida is a leading cause of esophagitis (inflammation in the swallowing tube) in people with AIDS.
Almost 15% of people with weakened immune systems develop a systemic illness caused by Candida. These infections enter into the bloodstream through breakdowns or cuts in the skin or mucous membranes. Candidal organisms may build up in an area because of frequent use of antibiotics, which kill the bacteria that normally keep them under control.
Use of devices implanted in the skin such as urinary catheters and IV ports also provide access for the yeast to enter the body. IV drug users utilizing dirty needles may inject the yeast directly into their bloodstream or deep tissues.
Candidiasis Yeast Infection Symptoms and Signs
Signs and symptoms of a candidal infection can vary depending on the location of the infection.
In women, signs and symptoms of a vaginal yeast infection are a white discharge that is thick and often described as having a cottage cheese appearance. The infection typically causes itching and irritates the vagina and surrounding outer tissues. On occasion there may be pain with sexual intercourse or burning with urination.
In infants and adults, a candidal infection can appear many different ways.
Oral candidiasis is called thrush. Thick, white lacy patches on top of a red base can form on the tongue, palate, or elsewhere inside the mouth. These patches sometimes look like milk curds but cannot be wiped away as easily as milk can. If the white plaques are wiped away with a blade or cotton-tipped applicator, the underlying tissue may bleed. This infection also may make the tongue look red without the white coating. Thrush can be painful and make it difficult to eat. Care should be given to make sure a person with thrush does not become dehydrated. Thrush was formerly referred to as moniliasis, based upon an older name for Candid albicans (Monilia).
Candidal organisms naturally live on the skin, but breakdown of the outer layers of skin promote the yeast’s overgrowth. This typically occurs when the environment is warm and moist such as in diaper areas and skin folds. Superficial candidal skin infections appear as a red flat rash with sharp scalloped edges. There are usually smaller patches of similar appearing rash nearby, known as “satellite lesions.” These rashes may cause itching or pain.
In people with weakened immune systems, candidal infections can affect various internal organs and cause pain or dysfunction of the organ. People with suppressed immune systems due to AIDS, chemotherapy, or other conditions may contract a yeast infection called esophagitis in their upper gastrointestinal (GI) systems. This infection is similar to thrush but extends down the mouth and esophagus to the stomach. Candida esophagitis can cause painful ulcers throughout the GI system, making it too painful to swallow even liquids. If the infection spreads into the intestines, food may be poorly absorbed. People with this condition are in danger of becoming dehydrated. There may be associated pain in the area of the sternum (breast bone), pain in the upper abdomen, and/or nausea and vomiting.
If Candida gets into the bloodstream, the person may become sick with or without fever. If the infection spreads to the brain, they may have acute changes in mental function or behavior.
When to go to the hospital
Most cases of candidiasis do not have to be treated in the hospital. People with weakened immune systems may have more serious infections, however, and may need to be hospitalized.
Women should go to the hospital when fever, chills, nausea and vomiting, or abdominal pain accompanies vaginal discharge. These symptoms can indicate a more serious problem such as kidney infections, appendicitis, or pelvic inflammatory disease. These potential conditions need to be investigated promptly.
If thrush interferes with drinking liquids or eating for long periods of time, people may need to be hospitalized for more aggressive medications and reestablishing body fluids.
Candidal skin infections rarely require hospital treatment.
People with weak immune systems run the risk of the candidal organisms spreading to their blood or internal organs, which can cause life-threatening illness. IV medication may be necessary to combat this systemic illness. Your doctor should promptly investigate symptoms of illness or general malaise.
Melissa Conrad Stöppler, MD