Candidiasis
Candidiasis (candidosis, moniliasis, "yeast infection") is infection caused by species of Candida, especially Candida albicans.
Candida is normally present on the skin, in the intestinal tract, and--in women--in the genital region. Usually, Candida in these areas does not cause problems. Sometimes, however, the fungus can cause infection of the skin (see Section 18, Chapter 212) or the mucous membranes of the mouth (see Section 8, Chapter 110 and Section 8, Chapter 115) or vagina (see Section 22, Chapter 247). Such infections can develop in people with a healthy immune system, but they are more common or persistent in people with diabetes, cancer, or AIDS and in pregnant women. Candidiasis is also common in people who are given antibiotics, because the bacteria that normally compete with Candida are killed and the fungus is able to grow unchecked.
Some people, mainly those with a weakened immune system, develop candidiasis that spreads through the bloodstream to other parts of the body.
Symptoms and Diagnosis
Infection of the mouth (thrush or trench mouth) causes creamy, white, painful patches to form inside the mouth. Skin infections can cause a burning rash. Patches in the esophagus cause pain with swallowing.
More serious infections, such as those in the heart valves, can cause fever, heart murmur, and enlargement of the spleen. An infection of the retina and inner parts of the eye can cause blindness. An infection of the blood (candidemia) or kidney can cause fever, very low blood pressure (shock), and a decrease in urine production.
Many candidal infections are apparent from the symptoms alone. To confirm the diagnosis, however, a doctor must identify the fungi in a skin sample under a microscope. Samples of blood or spinal fluid that have been cultured may also reveal the presence of the fungus.
Prognosis and Treatment
Candidiasis that occurs only on the skin or in the mouth or vagina can be treated with antifungal drugs that are applied directly to the affected area (for example, clotrimazole and nystatin). A doctor may prescribe the antifungal drug fluconazole to be taken by mouth.
Candidiasis that has spread throughout the body is a severe, progressive, and potentially fatal infection that is usually treated with intravenous amphotericin B, although fluconazole is effective for some people. Caspofungin and voriconazole, drugs that are still being studied, may be useful as well.
Certain medical conditions, such as diabetes, can worsen candidiasis. In people with diabetes, control of the blood sugar levels facilitates cure of the infection.
|
