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 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

• 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)

• Very rarely, infection may become invasive, spreading throughout the body, resulting in fevers along with other Sx depending on parts of the body affected

• 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

• 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

• 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

• Vaginal yeast infection
• Vaginitis (candidiasis is a common cause of vaginitis)
• Bacterial vaginosis (white-grey discharge, fishy smell)
• Trichomonas (yellow-green discharge, fishy smell)
• Vaginal discharge