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Kandidiasis

Candidiasis is a fungal infection caused by yeasts that belong to the genus Candida. There are over 20 species of Candida yeasts that can cause infection in humans, the most common of which is Candida albicans. Candida yeasts normally live on the skin and mucous membranes without causing infection; however, overgrowth of these organisms can cause symptoms to develop. Symptoms of candidiasis vary depending on the area of the body that is infected. Candidiasis that develops in the mouth or thro at is called thrush or oropharyngeal candidiasis. Candidiasis in the vagina is commonly referred to as a yeast infection. Invasive candidiasis occurs when Candida species enter the bloodstream and spread throughout the body. Click the links below for more information on the different types of Candida infections.

Types of Candidiasis

Thrush (Oropharyngeal / Esophageal Candidiasis) Vaginal Yeast Infections (Genital / Vulvovaginal Candidiasis) Invasive Candidiasis

Definition of Oral Candidiasis


Candidiasis of the mouth and throat, also known as thrush" or oropharyngeal candidiasis, is a fungal infection that occurs when there is overgrowth of a yeast called Candida. Candida yeasts normally live on the skin or mucous membranes in small amounts. However, if the environment inside the mouth or throat becomes imbalanced, the yeasts can multiply and cause symptoms.Candida overgrowth can also develop in the esophagus, and this is called Candida esophagitis, or esophageal candidiasis.

Symptoms of Oral Candidiasis


Candida infections of the mouth and throat can manifest in a variety of ways. The most common symptom of oral thrush is white patches or plaques on the tongue and other oral mucous membranes. Other symptoms include:

Redness or soreness in the affected areas Difficulty swallowing

Cracking at the corners of the mouth (angular cheilitis)

It is important to see your doctor if you have any of these symptoms.

Risk & Prevention


Who Gets Oral Candidiasis?
Candida infections of the mouth and throat are uncommon among adults who are otherwise healthy. Oral thrush occurs most frequently among babies less than one month old, the elderly, and groups of people with weakened immune systems. Other factors associated with oral and esophageal candidiasis include:

HIV/AIDS Cancer treatments Organ transplantation Diabetes Corticosteroid use Dentures Broad-spectrum antibiotic use

How Can I Prevent Oral Candidiasis?


Good oral hygiene practices may help to prevent oral thrush in people with weakened immune systems. Some studies have shown that chlorhexidine (CHX) mouthwash can help to prevent oral candidiasis in people undergoing cancer treatment. People who use inhaled corticosteroids may be able to reduce the risk of developing thrush by washing out the mouth with water or mouthwash after using an inhaler.

Sources of Oral Candidiasis


Candida species are normal inhabitants of the mouth, throat, and the rest of the gastrointestinal tract. Usually, Candida yeasts live in and on the body in small amounts and do not cause any harm. However, the use of certain medications or a weakening of the immune system can causeCandida to multiply, which may cause symptoms of infection.

Oral Candidiasis Statistics


The infection is not very common in the general population. It is estimated that between 5% and 7% of babies less than one month old will develop oral candidiasis. The prevalence of oral candidiasis among AIDS patients is estimated to be between 9% and 31%, and studies have documented clinical evidence of oral candidiasis in nearly 20% of cancer patients.

Diagnosis & Testing of Oral Candidiasis


A healthcare provider diagnoses the infection based on your symptoms, and by taking a scraping of the affected areas to examine under a microscope. A culture may also be performed; however, because Candida organisms are normal inhabitants of the human mouth, a positive culture by itself does not make the diagnosis.

Treatment & Outcomes of Oral Candidiasis


Candida infections of the mouth and throat must be treated with prescription antifungal medication. The type and duration of treatment depends on the severity of the infection and patient-specific factors such as age and immune status. Untreated infections can lead to a more serious form of invasive candidiasis. Oral candidiasis usually responds to topical treatments such as clotrimazole troches and nystatin suspension (nystatin swish and swallow). Systemic antifungal medication such as fluconazole or itraconazole may be necessary for oropharyngeal infections that do not respond to these treatments. Candida esophagitis itraconazole. For is typically or treated with oral or intravenous fluconazole or oral with severe azole-resistant esophageal candidiasis, treatment

amphotericin B may be necessary. For healthcare providers: the most up-to-date clinical practice guidelines for the treatment of oropharyngeal / esophageal candidiasis are available at the Infectious Diseases Society of America.

Definition of Invasive Candidiasis


Invasive candidiasis is a fungal infection that can occur when Candida yeasts enter the bloodstream. Once the fungus is in the bloodstream, it can spread to other parts of the body and cause infection.

Symptoms of Invasive Candidiasis


The symptoms of invasive candidiasis are not specific. Fever and chills that do not improve after antibiotic therapy are the most common symptoms. If the infection spreads to other organs or parts of the body such as kidneys, liver, bones, muscles, joints, spleen, or eyes, additional symptoms may develop, which vary depending on the site of infection. If the infection does not respond to treatment, the patients organs may stop working.

Risk & Prevention

People at Risk for Invasive Candidiasis

Who Gets Invasive Candidiasis?

Candidemia (a bloodstream infection with Candida), is the fourth most common bloodstream infection among hospitalized patients in the United States. People at high risk for developing candidemia include:

Intensive care unit (ICU) patients Surgical patients Patients with a central venous catheter People whose immune systems are weakened (such as people with HIV/AIDS) Very low-birth-weight infants

How Can Invasive Candidiasis be Prevented?


Antifungal prophylaxis may be appropriate for some groups of people who are at high risk of developing candidemia, such as low-birth-weight infants. Doctors and nurses can follow CDC-recommended infection control steps every time they work with a central line. Patients and caregivers can ask if a central line is needed and, if so, how long it should stay in place. They can also make sure that healthcare professionals wash their hands before they care for the central line. Patients should speak up if the skin around the central line becomes sore or red, or if their bandages are wet or dirty. For more information on how to prevent healthcare-associated bloodstream infections, visit the CDC's Vital Signs Making Health Care Safer web page.

Sources of Invasive Candidiasis


risk, invasive candidiasis may occur

Candida yeasts normally live in and on the body without causing any symptoms. In people at when a persons own Candida yeasts enter the bloodstream. This can also happen if medical equipment or devices, particularly intravenous (IV) catheters, become contaminated with Candida. In either case, the infection may spread through the bloodstream and infect various organs

Invasive Candidiasis Statistics


Invasive candidiasis is extremely rare in people without risk factors, but it is the fourth most common cause of hospital-acquired bloodstream infections in the U.S. In the general population, the incidence is 8 to 10 cases per 100,000 people. A higher incidence has been observed among Blacks/African-Americans and babies less than one month old. It is estimated that between 5% and 20% of newborns that weigh less than 1000 grams (2.2 pounds) at birth develop invasive candidiasis.

Diagnosis & Testing of Invasive Candidiasis


Invasive candidiasis is primarily diagnosed through blood culture.

Treatment & Outcomes of Invasive Candidiasis


Invasive candidiasis requires treatment with oral or intravenous (IV) antifungal medication for several weeks. The type and duration of antifungal treatment will depend on patient-specific factors such as age, immune status, and severity of infection. Treatment of invasive candidiasis should include prompt removal of catheters. Neonates with invasive candidiasis should be treated with amphotericin B for at least 3 weeks. For clinically stable children and adults, fluconazole or an echinocandin (caspofungin, micafungin, or anidulafungin) is the recommended form of therapy. In critically ill patients, an echinocandin or a lipid formulation of amphotericin B is recommended. Treatment should continue for 2 weeks after signs and symptoms of candidemia have resolved and the Candida yeasts have been cleared from the bloodstream. For healthcare providers: the most up-to-date clinical practice guidelines for the treatment of invasive candidiasis can be found at the Infectious Diseases Society of America website.