Candidiasis is a fungal infection due to any type of Candida (i.e. a type of yeast). Thrush is when it affects the mouth. Yeast infection is when it affects the vagina.
Sx
Sx vary depending on the area affected. Most candida infections result in minimal complications, e.g. redness, itching, and discomfort, although complications may be severe or even fatal if left untreated in certain populations
Thrush (mouth):
White patches on the tongue, or other areas of the mouth and throat
Soreness and problems with swallowing
Yeast infection (vagina):
Genital itching
Burning
Cottage cheese-like discharge from the vagina
Les commonly, the penis may be affected, resulting in itchiness
Pathophysiology
More than 20 types of Candida can cause infection, with Candida albicans being the most common
In immunocompetent patients, it is usually a very localized infection of the skin or mucosal membranes, including the oral cavity (thrush), the pharynx or esophagus, the GI tract, the rectum, anus, perianal/perirectal or anorectal area (in men as well as women), the perineum, the urinary bladder, the fingernails or toenails (onychomycosis), and genitalia (vagina, penis, etc)
Prognosis
Very rarely, infection may become invasive, spreading throughout the body, resulting in fevers along with other Sx depending on parts of the body affected
Risk factors
Thrush (mouth) is most common amongst:
Extremities of age (children<1 mo old, elderly)
Weak immune system (including HIV/AIDS, medication used after organ transplant, diabetes, corticosteroid use)
Dentures
After abx therapy
Yeast infection (vagina) more common:
During pregnancy
Weak imune system
Following abx use
Widespread infection more common:
In ICU
Following surgery
LBW infants
Weak immune systems
Tx
Prevention, including:
Thrush (mouth):
Use of chlorhexidine mouth wash in those with poor immune function
Washing out the mouth following use of inhaled steroids
Yeast infection (vaginal):
In those at very high risk, antifungals may be used preventatively
Tx:
Thrush (mouth):
Topical clotrimazole, or nystatin
Next line, fluconazole, itraconazole, amphotericin B
Yeast infection (vaginal):
Topical antifungals, e.g. clotrimazole
In those with widespread disease, IV amphotericin B for weeks is often used
Little evidence, for probiotics, even in those with frequent vaginal infections
Epidemiology
Thrush (mouth) occurs in 6% of babies<1 month old
20% of those on chemotherapy for cancer, and 20% of those with AIDS, also develop candidiasis
75% of women have at least 1 yeast infection at some time in their lives
Widespread disease is rare except in those with risk factors
See also
Vaginal yeast infection
Vaginitis (candidiasis is a common cause of vaginitis)
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