Doctor's Notes on Candidiasis
- Oral candidiasis (also termed thrush) – thick white lacy patches on top of a red base almost anywhere inside the mouth and the tongue may look red without the white coating,
- candidiasis on the skin – mainly occurs in warm and moist areas such as diaper area and/or skinfolds as a red flat reddish area with sharp scalloped edges; the areas may be itchy and/or painful,
- candidiasis associated with people that have weakened immune systems – oral candidiasis that may extend into the upper gastrointestinal tract and may produce ulcers, difficult to swallow foods and liquids, nausea, vomiting and chest pain,
- blood-borne candidiasis – possible fever, mental status changes,
- genital candidiasis – in women, a thick white discharge resembling with itching and irritation of the vagina and surrounding tissue; burning with urination and/or discomfort and pain with sexual intercourse – in men, symptoms include itching and burning of the penis and a reddish rash on the skin of the penis,
The cause of candidiasis is usually a yeast infection by Candida albicans. These yeast commonly are found on the skin and mucosal surfaces of healthy individuals. Yeast cause infections when local conditions (cracks in skin, skin is kept included and/or wet or damp, individuals have poor or depressed immune response) encourage rapid yeast growth.
(Yeast Infection) Symptoms
Signs and symptoms of a candida infection can vary depending on the location of the infection.
- In women, signs and symptoms of a vaginal yeast infection are a white discharge that is thick and often described as having a cottage cheese appearance. The infection typically causes itching and irritates the vagina and surrounding outer tissues. On occasion there may be pain with sexual intercourse or burning with urination.
- Genital yeast infection in men: Men may develop symptoms of a genital yeast infection after intercourse with a woman who has a vaginal yeast infection. However, yeast infection is not considered to be a sexually-transmitted disease (STD) because women can have the yeast normally in the body and do not acquire it from an outside source. Most experts do not recommend treatment of male sex partners of women with candida yeast infection unless they develop symptoms. Symptoms can include itching and burning of the penis as well as a rash on the skin of the penis.
- In infants and adults, a candida infection can appear many different ways.
- Oral candidiasis is called thrush. Thick, white lacy patches on top of a red base can form on the tongue, palate, or elsewhere inside the mouth. These patches sometimes look like milk curds but cannot be wiped away as easily as milk can. If the white plaques are wiped away with a blade or cotton-tipped applicator, the underlying tissue may bleed. This infection also may make the tongue look red without the white coating. Thrush can be painful and make it difficult to eat. Care should be given to make sure a person with thrush does not become dehydrated. Thrush was formerly referred to as moniliasis, based upon an older name for Candid albicans (Monilia).
- Candida organisms naturally live on the skin, but breakdown of the outer layers of skin promote the yeast's overgrowth. This typically occurs when the environment is warm and moist such as in diaper areas and skin folds. Superficial candida skin infections appear as a red flat rash with sharp scalloped edges. There are usually smaller patches of similar appearing rash nearby, known as "satellite lesions." These rashes may cause itching or pain.
- In people with weakened immune systems, candidal infections can affect various internal organs and cause pain or dysfunction of the organ. People with suppressed immune systems due to AIDS, chemotherapy, steroids or other conditions may contract a yeast infection called esophagitis in their upper gastrointestinal (GI) systems. This infection is similar to thrush but extends down the mouth and esophagus to the stomach. Candida esophagitis can cause painful ulcers throughout the GI system, making it too painful to swallow even liquids. If the infection spreads into the intestines, food may be poorly absorbed. People with this condition are in danger of becoming dehydrated. There may be associated pain in the area of the sternum (breast bone), pain in the upper abdomen, and/or nausea and vomiting.
- If Candida gets into the bloodstream, the person may become sick with or without fever. If the infection spreads to the brain, they may have acute changes in mental function or behavior.
(Yeast Infection) Causes
- In women, yeast infections are the second most common reason for vaginal burning, itching, and discharge. Yeast are found in the vagina of 20% to 50% of healthy women and can overgrow if the environment in the vagina changes. Antibiotic and steroid use is the most common reason for yeast overgrowth. However, pregnancy, menstruation, diabetes, and birth control pills also can contribute to getting a yeast infection. Yeast infections are more common after menopause
- In people who have a weakened immune system because of cancer treatments, steroids, or diseases such as AIDS, candida infections can occur throughout the entire body and can be life-threatening. The blood, brain, eye, kidney, and heart are most frequently affected, but Candida also can grow in the lungs, liver, and spleen. Candida is a leading cause of esophagitis (inflammation in the swallowing tube) in people with AIDS.
- Almost 15% of people with weakened immune systems develop a systemic illness caused by Candida. These infections enter into the bloodstream through breakdowns or cuts in the skin or mucous membranes. Candidal organisms may build up in an area because of frequent use of antibiotics, which kill the bacteria that normally keep them under control.
- Use of implanted devices and tubes that penetrate into the body like urinary catheters and IV ports/lines also provide access for the yeast to enter the body. IV drug users utilizing dirty needles may inject the yeast directly into their bloodstream or deep tissues.
Urinary tract infection (UTI) symptoms can be frightening and a cause for concern. Some people who have a UTI don't have any symptoms. Sometimes a doctor may diagnose a UTI based on the description of the patient's symptoms and ruling out other potential causes. The following slides describe common symptoms of a UTI.
Ringworm : Test your Medical IQ QuizQuestion
Ringworm is caused by a fungus.See Answer
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.