Candidiasis (Brut)

Candidiasis
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"Thrush (infection)" redirects here. For the hoof infection, see Thrush (horse).
Candidiasis
Classification and external resources
Oral candidiasis (thrush)
ICD-10 B37
ICD-9 112
DiseasesDB 1929
MedlinePlus 001511
eMedicine med/264 emerg/76 ped/312 derm/67
MeSH D002177
Candidiasis or thrush is a fungal infection (mycosis) of any of the Candida species (all
yeasts), of which Candida albicans is the most common.[1][2] Also commonly referred to
as a yeast infection, candidiasis is also technically known as candidosis, moniliasis, and
oidiomycosis.[3]
Candidiasis encompasses infections that range from superficial, such as oral thrush and
vaginitis, to systemic and potentially life-threatening diseases. Candida infections of the
latter category are also referred to as candidemia and are usually confined to severely
immunocompromised persons, such as cancer, transplant, and AIDS patients, as well as
nontrauma emergency surgery patients.[4]
Superficial infections of skin and mucosal membranes by Candida causing local

inflammation and discomfort are common in many human populations.[2][5][6] While
clearly attributable to the presence of the opportunistic pathogens of the genus Candida,
candidiasis describes a number of different disease syndromes that often differ in their
causes and outcomes.[2][5]
Differential Diagnosis
Classification
Candidiasis may be divided into the following types:[3]
 Angular cheilitis (perlèche)

 Antibiotic candidiasis (iatrogenic candidiasis)
 Candidal intertrigo
 Candidal paronychia
 Candidal vulvovaginitis (vaginal yeast infection)
 Candidid
 Chronic mucocutaneous candidiasis
 Congenital cutaneous candidiasis
 Diaper candidiasis
 Erosio interdigitalis blastomycetica
 Oral candidiasis (thrush)
 Perianal candidiasis
 Systemic candidiasis
Signs and symptoms

Skin candidiasis
Nail candidiasis (onychomycosis)
Symptoms of candidiasis vary depending on the area affected.[7] Most candidial infections
result in minimal complications such as redness, itching and discomfort, though
complications may be severe or fatal if left untreated in certain populations. In
immunocompetent persons, candidiasis is usually a very localized infection of the skin or
mucosal membranes, including the oral cavity (thrush), the pharynx or esophagus, the
gastrointestinal tract, the urinary bladder, or the genitalia (vagina, penis).[1]
Candidiasis is a very common cause of vaginal irritation, or vaginitis, and can also occur
on the male genitals. In immunocompromised patients, Candida infections can affect the
esophagus with the potential of becoming systemic, causing a much more serious
condition, a fungemia called candidemia.[5][6]
Thrush is commonly seen in infants. It is not considered abnormal in infants unless it

lasts longer than a few weeks.[8]
Infection of the vagina or vulva may cause severe itching, burning, soreness, irritation,
and a whitish or whitish-gray cottage cheese-like discharge, often with a curd-like
appearance. These symptoms are also present in the more common bacterial vaginosis.[9]
In a 2002 study published in the Journal of Obstetrics and Gynecology, only 33% of
women who were self-treating for a yeast infection actually had a yeast infection, while
most had either bacterial vaginosis or a mixed-type infection.[10] Symptoms of infection of
the male genitalia include red, patchy sores near the head of the penis or on the foreskin,
severe itching, or a burning sensation. Candidiasis of the penis can also have a white
discharge, although uncommon.[citation needed]
Causes
See also: Candida albicans
Candida yeasts are commonly present in humans, and their growth is normally limited by
the human immune system and by other microorganisms, such as bacteria occupying the
same locations in the human body.[11]
C. albicans was isolated from the vaginas of 19% of apparently healthy women, i.e.,
those who experienced few or no symptoms of infection. External use of detergents or
douches or internal disturbances (hormonal or physiological) can perturb the normal
vaginal flora, consisting of lactic acid bacteria, such as lactobacilli, and result in an
overgrowth of Candida cells, causing symptoms of infection, such as local inflammation.
[12]
Pregnancy and the use of oral contraceptives have been reported as risk factors.[13]
Diabetes mellitus and the use of antibacterial antibiotics are also linked to an increased
incidence of yeast infections.[13] Diets high in simple carbohydrates have been found to
affect rates of oral candidiases,[14] and hormone replacement therapy and infertility
treatments may also be predisposing factors.[15] Wearing wet swimwear for long periods
of time is also believed to be a risk factor.[2]
A weakened or undeveloped immune system or metabolic illnesses such as diabetes are

significant predisposing factors of candidiasis.[16] Diseases or conditions linked to
candidiasis include HIV/AIDS, mononucleosis, cancer treatments, steroids, stress, and
nutrient deficiency. Almost 15% of people with weakened immune systems develop a
systemic illness caused by Candida species.[17] In extreme cases, these superficial
infections of the skin or mucous membranes may enter into the bloodstream and cause
systemic Candida infections.
In penile candidiasis, the causes include sexual intercourse with an infected individual,
low immunity, antibiotics, and diabetes. Male genital yeast infections are less common,
and incidences of infection are only a fraction of those in women; however, yeast
infection on the penis from direct contact via sexual intercourse with an infected partner
is not uncommon.[18]
Candida species are frequently part of the human body's normal oral and intestinal flora.
Treatment with antibiotics can lead to eliminating the yeast's natural competitors for
resources, and increase the severity of the condition.[citation needed] Higher prevalence of
colonization of C. albicans was reported in young individuals with tongue piercing, in
comparison to unpierced matched individuals.[19] In the Western Hemisphere, about 75%
of females are affected at some time in their lives.
Diagnosis
Agar plate culture of C. albicans
Micrograph of esophageal candidiasis, biopsy specimen, PAS stain
Diagnosis of a yeast infection is done either via microscopic examination or culturing.
For identification by light microscopy, a scraping or swab of the affected area is placed
on a microscope slide. A single drop of 10% potassium hydroxide (KOH) solution is then
added to the specimen. The KOH dissolves the skin cells, but leaves the Candida cells
intact, permitting visualization of pseudohyphae and budding yeast cells typical of many
Candida species.
For the culturing method, a sterile swab is rubbed on the infected skin surface. The swab
is then streaked on a culture medium. The culture is incubated at 37°C for several days, to
allow development of yeast or bacterial colonies. The characteristics (such as
morphology and colour) of the colonies may allow initial diagnosis of the organism
causing disease symptoms.[20]
Treatment
In clinical settings, candidiasis is commonly treated with antimycotics; the antifungal
drugs commonly used to treat candidiasis are topical clotrimazole, topical nystatin,
fluconazole, and topical ketoconazole.
For example, a one-time dose of fluconazole (150-mg tablet taken orally) has been
reported as being 90% effective in treating a vaginal yeast infection.[21] This dose is only
effective for vaginal yeast infections, and other types of yeast infections may require
different dosing. In severe infections, amphotericin B, caspofungin, or voriconazole may
be used. Local treatment may include vaginal suppositories or medicated douches.
Gentian violet can be used for thrush in breastfeeding babies, but when used in large
quantities, it can cause mouth and throat ulcerations, and has been linked to mouth cancer
in humans and to cancer in the digestive tract of other animals.[22]
Chlorhexidine gluconate oral rinse is not recommended to treat candidiasis,[23] but is

effective as prophylaxis;[24] chlorine dioxide rinse was found to have similar in vitro
effectiveness against Candida.[25]
C. albicans can develop resistance to antimycotic drugs.[26] Recurring infections may be

treatable with other antifungal drugs, but resistance to these alternative agents may also
develop.

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Candidiasis

From Wikipedia, the free encyclopedia

Classification and external resources

Oral candidiasis (thrush)

eMedicine med/264 emerg/76 ped/312 derm/67

Superficial infections of skin and mucosal membranes by Candida causing local

 Angular cheilitis (perlèche)

Signs and symptoms

Nail candidiasis (onychomycosis)

Thrush is commonly seen in infants. It is not considered abnormal in infants unless it

A weakened or undeveloped immune system or metabolic illnesses such as diabetes are

Agar plate culture of C. albicans

Micrograph of esophageal candidiasis, biopsy specimen, PAS stain

Diagnosis of a yeast infection is done either via microscopic examination or culturing.

Chlorhexidine gluconate oral rinse is not recommended to treat candidiasis,[23] but is

C. albicans can develop resistance to antimycotic drugs.[26] Recurring infections may be

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