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Salem Health: Infectious Diseases & Conditions, 2nd Edition

Candidiasis

by Marylane Wade Koch, , M.S.N., R.N.

Category: Diseases and conditions

Anatomy or system affected: Gastrointestinal system, genitalia, intestines, mouth, skin

Also known as: Moniliasis, thrush, yeast infection

Definition

Candidiasis is a yeast infection caused by the Candida fungi. C. albicans is the most common of about twenty types of Candida.

Causes

Candida fungi coexist with bacteria normally occurring in the human intestine, mouth, vagina, bowels, and skin. Usually the immune system maintains a balance in these organisms. An imbalance leads to an overgrowth of Candida and the development of candidiasis.

The use of antibiotics and steroids can disturb this balance by suppressing the normal bacteria flora that keep Candida in check. The Candida fungi multiply and flourish, causing a yeast infection. Factors that contribute to vaginal candidiasis include taking birth control pills, being pregnant, and having diabetes. Spermicidal foams can change the balance of bacteria in the vagina. Any factor that suppresses the immune system can contribute to candidiasis.

Candida thrives in warm, moist places. A cutaneous candidiasis may present as a rash on various parts of the body, including the groin, underarms, and under the female breast. Candida also is often the cause of diaper rash.

Risk Factors

Persons at risk for candidiasis include those with chronic diseases who are on long-term, broad-spectrum antibiotic therapy. However, some persons may experience candidiasis while taking antibiotics for a short time. Others at risk include people with compromised immune systems or who have autoimmune diseases (such as cancer and human immunodeficiency virus, or HIV, infection). Diabetics may be more susceptible to candidiasis because of the growth of fungus in the presence of sugar. High-stress lifestyles can lower immune-system function and predispose a person to candidiasis. Persons with urinary catheters or persons who use intravenous drugs may be prone to candidiasis. A break in the skin can result in a life-threatening blood infection known as systemic candidiasis.

Symptoms

Symptoms of a candidiasis depend on the location of the infection. A woman who has vaginal candidiasis will likely experience burning during urination and itching of the vulva. Sexual intercourse may be painful because of irritation and swelling of the female organs. A vaginal discharge will present as either thick, white, and clumpy (like cottage cheese) or thin and watery with a characteristic yeast odor.

The infant or toddler with a diaper rash may have red, itchy bumps or papules or a raw, painful rash. If the yeast infection occurs in the mouth or throat to become thrush, white patches will likely appear on the tongue and oral mucosa. Oral yeast can form around dentures. The affected person or infant with oral thrush may experience difficulty swallowing.

Cutaneous candidiasis may present as pimples at the base of hair follicles or as a rash under the arms or breasts or around the genital area, groin, or folds of skin. The infected skin may become inflamed with intense itching.

Candidiasis can affect the internal organs in persons with a suppressed immune system. A person undergoing chemotherapy or a person who has acquired immunodeficiency syndrome (AIDS) may experience oral candidiasis that spreads down the throat, causing esophagitis, or spreads into the stomach and the rest of the gastrointestinal system. These persons tend to become dehydrated and show symptoms such as fever, rash, or chills, indicating possible extensive disease involvement. One should seek immediate treatment if these symptoms appear.

Screening and Diagnosis

A health care provider can diagnosis candidiasis by physical examination. To diagnosis oral candidiasis or thrush, the provider examines the mucous membranes of the mouth for white patches that look like milk curds that cannot be wiped off. Cutaneous candidiasis can be diagnosed by inspecting the affected skin and collecting scrapings for microscopic review. Vaginal candidiasis can be diagnosed by the appearance and yeastlike odor of the discharge and by a culture obtained during a pelvic exam. Internal organ disease may require computed tomography (CT) or magnetic resonance imaging (MRI) scans or a biopsy for definitive diagnosis. Systemic candidiasis infectionsmay be detected with blood sample testing. Undiagnosed immune deficiency diseases, such as leukemia or AIDS, can be discovered secondary to diagnosis of candidiasis.

Treatment and Therapy

Candidiasis is treated based on the location and severity of the infection. Cutaneous skin infections require the use of a topical antifungal medication. Diaper rash can be treated with over-the-counter powders or creams such as Mycostatin. Vaginal yeast infections require intravaginal antifungal creams or suppositories such as miconazole (Monistat) or an oral antifungal medication such as fluconazole (Diflucan), or both. For thrush, an oral antifungal mouth rinse such as nystatin or a medicated oral lozenge may be recommended. If the infection is systemic or life-threatening, intravenous antifungal medications such as amphotericin B may be prescribed.

Complementary or natural therapy practitioners recommend taking dietary supplements such as garlic, digestive enzymes, psyllium husk and seed powder, and homeopathic tinctures. A diet designed to starve the yeast would limit the intake of sugar, alcohol, and refined and processed foods. Acupuncture may be used to boost the immune system.

Prevention and Outcomes

To prevent candidiasis, some practitioners prescribe probiotics and yogurt to prevent growth of Candida and to return the balance of healthy normal flora. Avoiding the overuse of antibiotics can help maintain balance between Candida and normal bacteria

Though not considered a sexually transmitted disease, candidiasis should keep an infected person from having sexual intercourse until symptoms are gone. Also, one should avoid any contact with substances that can change the balance of normal flora bacteria of the vagina; these substances include douches, vaginal deodorants, and bubble bath.

Yeast thrives in warm, dark, and moist areas such as the groin, so wearing loose-fitting cotton undergarments may decrease the incidence of infection. Avoiding tight pantyhose (or nylons) in warm or hot weatheris recommended as well. One should also practice good personal hygiene and keep the skin clean and dry. Babies and toddlers should be kept clean and dry with frequent diaper changes. Other preventive measures include eating a healthy, well-balanced diet and drinking adequate fluids to promote a healthy immune system; restricting one’s intake of sugar, alcohol, and processed foods; maintaining control of blood sugar levels (especially persons with diabetes); and losing weight.

Further Reading

1 

Mandell, Gerald L., John E. Bennett, and Raphael Dolin, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. New York: Churchill Livingstone/Elsevier, 2010. An outstanding textbook on infectious diseases, with chapters on the various diseases caused by Candida, illnesses and conditions associated with this fungus, and antifungal agents.

2 

Margolis, Simon. Johns Hopkins Complete Home Guide to Symptoms and Remedies. New York: Black Dog and Leventhal, 2004. Provides insights on more than five hundred conditions, including candidiasis, with advice by leading specialists at Johns Hopkins Medical Center.

3 

National Library of Medicine. “Cutaneous Candidiasis.” Available at http://www.nlm.nih.gov/medlineplus/ency/article/000880.htm.

4 

Parker, James N., and Philip M. Parker, eds. The Official Patient’s Sourcebook on Genital Candidiasis. San Diego, Calif.: Icon Health, 2002. Draws from public, academic, government, and peer-reviewed research to provide a wide-ranging handbook for persons with candidiasis.

5 

Quick Access Patient Information on Conditions, Herbs, and Supplements. New York: Thieme, 2000. Provides information on common health conditions, including candidiasis, and alternative approaches for treatment. Includes reviews by physicians at noted universities and hospitals.

6 

Winn, Washington C., Jr., et al. Koneman’s Color Atlas and Textbook of Diagnostic Microbiology. 6th ed. Philadelphia: Lippincott Williams & Wilkins, 2006. A practical text with excellent tables, charts, and photographs of microorganisms, including Candida.

Web Sites of Interest

American Congress of Obstetricians and Gynecologists

http://www.acog.org

National Candida Center

http://www.nationalcandidacenter.com

National Women’s Health Information Center

http://www.womenshealth.gov

See also: Alternative therapies; Antibiotics: Types; Antifungal drugs: Types; Bacterial vaginosis; Candida; Cervical cancer; Fungal infections; Fungi: Classification and types; Intestinal and stomach infections; Mouth infections; Oral transmission; Pelvic inflammatory disease; Skin infections; Thrush; Trichomonas; Urinary tract infections; Vaginal yeast infection; Women and infectious disease.

Citation Types

Type
Format
MLA 9th
Koch, Marylane Wade. "Candidiasis." Salem Health: Infectious Diseases & Conditions, 2nd Edition, edited by H. Bradford Hawley, Salem Press, 2020. Salem Online, online.salempress.com/articleDetails.do?articleName=Infect2e_0102.
APA 7th
Koch, M. W. (2020). Candidiasis. In H. B. Hawley (Ed.), Salem Health: Infectious Diseases & Conditions, 2nd Edition. Salem Press. online.salempress.com.
CMOS 17th
Koch, Marylane Wade. "Candidiasis." Edited by H. Bradford Hawley. Salem Health: Infectious Diseases & Conditions, 2nd Edition. Hackensack: Salem Press, 2020. Accessed September 16, 2025. online.salempress.com.