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Candida Infection (Candidiasis)

Last updated May 16, 2018

Approved by: Krish Tangella MD, MBA, FCAP

GMS stain of a kidney tissue sample shows numerous darkly-stained yeast cells of the fungal organism, Candida albicans.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Cradle Cap
  • Moniliasis
  • Oidiomycosis

What is Candida Infection? (Definition/Background Information)

  • Candidiasis is a fungal infection caused by a yeast-like fungus, called Candida albicans
  • The yeast is always present on the body; however, Candidiasis occurs when there is an overgrowth of Candida, due to certain conducive factors
  • This can occur in many areas of the body, including the skin, mouth, vagina, stomach, and the urinary tract

The name of the fungal infection is based on the infected area:

  • Thrush - the mouth is infected
  • Esophagitis - the esophagus (food-pipe) is infected
  • Cutaneous Candidiasis - the skin is infected
  • Peronychial Candidiasis - infection is around the nails
  • Vaginal Yeast Infection - the vagina is infected
  • Deep Candidiasis - when the infection spreads in the blood stream

A diagnosis of the condition is made by cultures or through examination of the affected tissue, by a pathologist, under a microscope. The prognosis is excellent with proper treatment.

Who gets Candida Infection? (Age and Sex Distribution)

Any individual is prone to local infections of the skin, mouth, or vagina. But, the infection is especially frequent in:

  • Diabetic patients
  • Cancer patients
  • AIDS-infected individuals
  • Pregnant women
  • Those taking antibiotics

System-wide infections are commonly observed among individuals, who are:

  • Having a weak immune system
  • Critically ill
  • In the intensive care unit
  • Over the age of 65 years
  • Have undergone a gastrointestinal surgery
  • Suffering from kidney failure
  • Healthy infants, in some cases

What are the Risk Factors for Candida Infection? (Predisposing Factors)

Risk factors for Candidiasis include:

  • A weak immune system caused by diseases/conditions like:
    • Diabetes
    • Organ transplant
    • Chemotherapy
    • AIDS
  • Undergoing regular systemic corticosteroid treatment
  • Breaks in the skin or mucous membranes
  • Kidney dialysis
  • Intravenous catheters
  • Intravenous drug abuse
  • Obesity
  • Peptic ulcer disease
  • Severe burns
  • Urinary catheters

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Candida Infection? (Etiology)

  • Candidiasis is a fungal infection caused by the microorganism Candida albicans
  • Candida albicansis is a yeast-like fungus that is always present on the body, in areas like the mouth, vagina, skin, gastrointestinal and urinary tracts
  • However, due to various reasons, there is an uncontrolled growth and proliferation of the pathogen, accompanied by pain, tenderness, and inflammation

Factors that favor an uncontrolled multiplication of the yeast include:

  • Extensive use/overuse of antibiotics
  • Use of steroids and cancer medications that weaken the immune system. This reduces the body’s defense system and allows the yeast to grow and multiply
  • Obesity: Warm moist skin folds are perfect environments for Candida growth
  • Pregnancy: Pregnancy weakens the immune system, increasing the risk of Candidiasis

What are the Signs and Symptoms of Candida Infection?

The signs and symptoms of Candidiasis are:

  • Red patches appearing in the skin, which are usually itchy and sometimes fluid-filled. These patches may be found in the groin, folds of the buttocks, under the breasts, or in abdominal folds, between the breasts, toes, fingers, and in the navel. Scabs are seen around the edges of the patches
  • A vaginal infection is characterized by thick, white, cheesy discharge, and is associated with itching, burning, or pain; especially,while urinating or during sexual intercourse
  • Painful, red, swollen areas around the finger nails, is the main symptom of Peronychial Candidiasis
  • Oral Thrush may show white patches inside the mouth (that resemble curd), on the tongue, palate, and around the lips
  • When the penis is infected, the area of the urethra or head of the penis may become red, swollen, and painful

How is Candida Infection Diagnosed?

A diagnosis of Candidiasis includes:

  • Physical examination with evaluation of medical history
  • The patient’s diet, and recent use of antibiotics/medications, is carefully examined by the physician to check, if there is any external cause that might have weakened the immune system
  • The patient’s history of diseases like diabetes, cancer, HIV, or other chronic diseases, is checked
  • The affected area is scraped and the sample studied under a microscope, to identify the yeast

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Candida Infection?

The following complications are likely to arise when an individual is infected by Candidiasis:

  • Swallowing difficulties: When the mouth or esophagus is infected, the lesions are very painful and may also bleed, making swallowing, painful and difficult
  • Damage to esophagus: Severe esophageal infection can lead to perforation and spread of infection inside the chest cavity
  • Chronic or recurrent infection occurs in women, who are infected with vaginal yeast infections. Long-standing lesions are perfect sites for secondary infections (infections caused by other organisms, like bacteria or virus, at the damaged site)
  • Candidiasis may lead to meningitis (yeast infection of the meninges around the brain), endocarditis (yeast infection of the sac around the heart), arthritis (yeast infection of the joint), and endophthalmitis (yeast infection within the eyeball)

How is Candida Infection Treated?

Treatment for Candidiasis depends upon the infected site, the patients’ underlying disease and immune status, and their risk factors. Treatments based on the infected sites include:

For skin infection:

  • Antifungal cream or powder are applied to the affected areas
  • Antifungal pills may also be recommended

For vaginal yeast infection:

  • Antifungal medications are administered directly (topically) into the vagina as tablets, creams, ointments, or suppositories
  • Antifungal medications, like flucanozole, may be administered by mouth

For Oral Thrush:

  • A suspension of antifungal medication can be swished in the mouth and swallowed
  • Use of antifungal lozenges, which dissolves in the mouth

Systemic (Deep) Candidiasis requires systemic therapy, such as fluconazole, and other additional treatment agents as well.

How can Candida Infection be Prevented?

The following preventive measures can be adopted for minimizing the risk of Candidiasis:

  • Use proper toilet hygiene (wipe from front to back)
  • Take bath, instead of showers
  • Dry area around the pubic hair thoroughly, after bathing
  • Do not apply soap to the vaginal area; it destroys the necessary bacteria and has no effect on the yeast
  • Sterilize or discard undergarments used, during a prior infection
  • Avoid tampons
  • Wear loose natural fiber (like cotton) undergarments
  • Avoid pantyhose and tight pants
  • Eat ‘live’ yogurt, instead of pasteurized yogurt
  • Limit the use of sugar and alcohol
  • Obtain advice from your physician, if you are a  woman experiencing recurrent infections and using birth-control pills

What is the Prognosis of Candida Infection? (Outcomes/Resolutions)

  • The prognosis for Candidiasis depends on the cause, severity, chronicity, and response to treatment. Generally, Candidiasis is not a serious disease and in healthy persons, the condition is easily treated
  • Genital Candidiasis needs treatment for several days
  • Oral Thrush is difficult to treat in individuals with weak immune systems including cancer, chemotherapy, or HIV/ AIDS

Additional and Relevant Useful Information for Candida Infection:

The fungus Candida albicansis also referred to as monilia; hence, Candidiasis is also called Moniliasis.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Nov. 13, 2013
Last updated: May 16, 2018