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Candidiasis

(Candidosis; Moniliasis; Yeast Infection)

By

Paschalis Vergidis

, MD, MSc, Mayo Clinic College of Medicine & Science

Reviewed/Revised Nov 2023
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Candidiasis is a fungal infection caused by several species of the yeast Candida, especially Candida albicans.

  • The most common type of candidiasis is a superficial infection of the mouth, vagina, or skin that causes white or red patches and itching, irritation, or both.

  • People whose immune system is weakened may have serious infections of the esophagus and other internal organs.

  • A sample of infected material is examined under a microscope and sent for culture.

  • Antifungal medications may be applied directly to the affected area or taken by mouth, but serious infections require medications given by vein.

Candida are yeast that are normally present on the skin, in the intestinal tract, and in the genital area. Usually, Candida in these areas does not cause problems. However, the fungi sometimes cause skin infections Candidiasis (Yeast Infection) Candidiasis is infection with the yeast Candida. Candidiasis tends to occur in moist areas of the skin. This skin infection may cause rashes, scaling, itching, and swelling. Doctors examine... read more Candidiasis (Yeast Infection) , mouth infections Thrush Candidiasis is infection with the yeast Candida. Candidiasis tends to occur in moist areas of the skin. This skin infection may cause rashes, scaling, itching, and swelling. Doctors examine... read more Thrush (affecting the mucous membranes), or infections of the vulva and vagina Overview of Vaginitis (Vaginal Infection or Inflammation) Vaginal infections are one of the most common reasons women see their doctor, accounting for millions of visits each year. Vaginal infections are caused by infectious organisms (such as bacteria... read more . Such infections can develop in people with a healthy immune system, but they are more common among or persistent in people with diabetes, cancer, or AIDS and in pregnant women. Candidiasis of the mouth and esophagus are common among people with AIDS. Candidiasis is also common among people who are taking antibiotics because the antibiotics kill the bacteria that normally live in the body and compete with Candida, allowing Candida to grow unchecked.

Candidiasis is bothersome but rarely life threatening. However, some forms of candidiasis are serious. They include

  • Invasive candidiasis

  • Candidemia (the most common form of invasive candidiasis)

In invasive candidiasis, the infection spreads to other parts of the body, such as the heart valves, brain, spleen, kidneys, and eyes. Invasive candidiasis occurs mainly in people with a weakened immune system and in hospitalized people. Candidiasis is one of the most common infections acquired in the hospital.

Candidemia is when candidal infection spreads through the bloodstream. It is a serious infection. In the United States, Candida is a common cause of bloodstream infections. The risk of developing this infection is increased by certain conditions, such as the following:

Candidemia is often fatal if not promptly treated.

Symptoms of Candidiasis

Infection of the mouth (thrush) causes the following:

  • Creamy, white, painful patches inside the mouth

  • Cracking at the corners of the mouth (cheilitis)

  • A red, painful, smooth tongue

Candidiasis of the Mouth

Patches in the esophagus cause pain or difficulty swallowing.

If the infection spreads to other parts of the body, it is more serious. It can cause fever, a heart murmur, enlargement of the spleen, dangerously low blood pressure (shock Shock Shock is a life-threatening condition in which blood flow to the organs is low, decreasing delivery of oxygen and thus causing organ damage and sometimes death. Blood pressure is usually low... read more ), and decreased urine production. An infection of the retina and inner parts of the eye can cause blindness.

If the infection is severe, several organs may stop functioning, and death can occur.

Diagnosis of Candidiasis

  • Examination and sometimes culture of a sample of blood or infected tissue

  • Sometimes blood tests

Many candidal infections are apparent from the symptoms alone.

To confirm the diagnosis, a doctor must identify the fungi in a sample viewed under a microscope. Samples of blood or other infected tissues may be sent to a laboratory to be cultured and examined to identify the fungi.

Doctors may do a blood test called the T2Candida Panel to detect Candida in the blood quickly and accurately. Other tests that detect genetic material in microorganisms Tests That Detect Genetic Material in Microorganisms Infectious diseases are caused by microorganisms, such as bacteria, viruses, fungi, and parasites. Doctors suspect an infection based on the person's symptoms, physical examination results,... read more may be done, including polymerase chain reaction (PCR). The PCR test is used to produce many copies of a gene from a microorganism, making the microorganism much easier to identify.

If candidemia is diagnosed, doctors may examine the eyes to determine whether the eyes are infected.

Treatment of Candidiasis

  • Antifungal medications

Candidiasis that occurs only on the skin or in the mouth or vagina can be treated with antifungal medications (such as clotrimazole and nystatin) that are applied directly to the affected area. A doctor may also prescribe the antifungal medication fluconazole to be taken by mouth.

For infections of the esophagus, doctors prescribe antifungal medications (such as fluconazole or itraconazole) to be taken by mouth. If these medications are ineffective or if the infection is severe, other antifungal medications are used.

Candidiasis that has spread throughout the body is usually treated with anidulafungin, caspofungin, or micafungin given intravenously or with fluconazole, which can be given intravenously or by mouth. If people cannot tolerate these medications, if these medications are not readily available, or if the infection is not eliminated by other antifungal medications, amphotericin B may be given intravenously.

Candidiasis is more serious and less responsive to treatment in people with certain disorders, such as diabetes. In people with diabetes, controlling blood sugar levels facilitates cure of the infection.

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