Candidiasis
candidiasis /can·di·di·a·sis/ (kan″dĭ-di´ah-sis) infection by fungi of the genus Candida, generally C. albicans, most commonly involving the skin, oral mucosa (thrush), respiratory tract, or vagina; rarely there is a systemic infection or endocarditis.
candidiasis
candidiasis [kan″dĭ-di´ah-sis]
candidiasis (kan·di·dīˑ·
·sis),
candidiasis (kan´didī
sis),
candidiasis
Definition
Candidiasis is an infection caused by a species of the yeast Candida, usually Candida albicans. This is a common cause of vaginal infections in women. Also, Candida may cause mouth infections in people with reduced immune function, or in patients taking certain antibiotics. Candida can be found in virtually all normal people but causes problems in only a fraction. In recent years, however, several serious categories of candidiasis have become more common, due to overuse of antibiotics, the rise of AIDS, the increase in organ transplantations, and the use of invasive devices (catheters, artificial joints and valves)—all of which increase a patient's susceptibility to infection.
Description
Vaginal candidiasis
Over one million women in the United States develop vaginal yeast infections each year. It is not life-threatening, but it can be uncomfortable and frustrating.
Oral candidiasis
This disorder, also known as thrush, causes white, curd-like patches in the mouth or throat.
Deep organ candidiasis
Also known as invasive candidiasis, deep organ candidiasis is a serious systemic infection that can affect the esophagus, heart, blood, liver, spleen, kidneys, eyes, and skin. Like vaginal and oral candidiasis, it is an opportunistic disease that strikes when a person's resistance is lowered, often due to another illness. There are many diagnostic categories of deep organ candidiasis, depending on the tissues involved.
Causes and symptoms
Vaginal candidiasis
Most women with vaginal candidiasis experience severe vaginal itching. They also have a discharge that often looks like cottage cheese and has a sweet or bread-like odor. The vulva and vagina can be red, swollen, and painful. Sexual intercourse can also be painful.
Oral candidiasis
Whitish patches can appear on the tongue, inside of the cheeks, or the palate. Oral candidiasis typically occurs in people with abnormal immune systems. These can include people undergoing chemotherapy for cancer, people taking immunosuppressive drugs to protect transplanted organs, or people with HIV infection.
Deep organ candidiasis
Anything that weakens the body's natural barrier against colonizing organisms—including stomach surgery, burns, nasogastric tubes, and catheters—can predispose a person for deep organ candidiasis. Rising numbers of AIDS patients, organ transplant recipients, and other individuals whose immune systems are compromised help account for the dramatic increase in deep organ candidiasis in recent years. Patients with granulocytopenia (deficiency of white blood cells) are particularly at risk for deep organ candidiasis.
Diagnosis
Often clinical appearance gives a strong suggestion about the diagnosis. Generally, a clinician will take a sample of the vaginal discharge or swab an area of oral plaque, and then inspect this material under a microscope. Under the microscope, it is possible to see characteristic forms of yeasts at various stages in the lifecycle.
Fungal blood cultures should be taken for patients suspected of having deep organ candidiasis. Tissue biopsy may be needed for a definitive diagnosis.
Treatment
Vaginal candidiasis
In most cases, vaginal candidiasis can be treated successfully with a variety of over-the-counter antifungal creams or suppositories. These include Monistat, Gyne-Lotrimin, and Mycelex. However, infections often recur. If a women has frequent recurrences, she should consult her doctor about prescription drugs such as Vagistat-1, Diflucan, and others.
Oral candidiasis
This is usually treated with prescription lozenges or mouthwashes. Some of the most-used prescriptions are nystatin mouthwashes (Nilstat or Nitrostat) and clotrimazole lozenges.
Deep organ candidiasis
The recent increase in deep organ candidiasis has led to the creation of treatment guidelines, including, but not limited to, the following: Catheters should be removed from patients in whom these devices are still present. Antifungal chemotherapy should be started to prevent the spread of the disease. Drugs should be prescribed based on a patient's specific history and defense status.
Alternative treatment
Home remedies for vaginal candidiasis include vinegar douches or insertion of a paste made from Lactobacillus acidophilus powder into the vagina. In theory, these remedies will make the vagina more acidic and therefore less hospitable to the growth of Candida. Fresh garlic (Allium sativum) is believed to have antifungal action, so incorporating it into the diet or inserting a gauze-wrapped, peeled garlic clove into the vagina may be helpful. The insert should be changed twice daily. Some women report success with these remedies; they should try a conventional treatment if an alternative remedy isn't effective.
Prognosis
Vaginal candidiasis
Although most cases of vaginal candidiasis are cured reliably, these infections can recur. To limit recurrences, women may need to take a prescription anti-fungal drug such as terconazole (sold as Terazol) or take other anti-fungal drugs on a preventive basis.
Oral candidiasis
These infections can also recur, sometimes because the infecting Candida develops resistance to one drug. Therefore, a physician may need to prescribe a different drug.
Deep organ candidiasis
The prognosis depends on the category of disease as well as on the condition of the patient when the infection strikes. Patients who are already suffering from a serious underlying disease are more susceptible to deep organ candidiasis that speads throughout the body.
Prevention
Because Candida is part of the normal group of microorganisms that co-exist with all people, it is impossible to avoid contact with it. Good vaginal hygiene and good oral hygiene might reduce problems, but they are not guarantees against candidiasis.
Because hospital-acquired (nosocomial) deep organ candidiasis is on the rise, people need to be made aware of it. Patients should be sure that catheters are properly maintained and used for the shortest possible time length. The frequency, length, and scope of courses of antibiotic treatment should also be cut back.
Resources
Periodicals
Greenspan, Deborah, and John S. Greenspan. "HIV-Related Oral Disease." The Lancet 348 (September 14, 1996): 729-734.
candidiasis /can·di·di·a·sis/ (kan″dĭ-di´ah-sis) infection by fungi of the genus Candida, generally C. albicans, most commonly involving the skin, oral mucosa (thrush), respiratory tract, or vagina; rarely there is a systemic infection or endocarditis.
acute pseudomembranous candidiasis thrush.
atrophic candidiasis a type of oral candidiasis marked by erythematous pebbled patches on the hard or soft palate, buccal mucosa, and dorsal surface of the tongue.
bronchopulmonary candidiasis bronchocandidiasis; that found in the respiratory tract.
chronic mucocutaneous candidiasis any of various forms characterized by chronic candidiasis of oral and vaginal mucosa, skin, and nails, resistant to treatment, and sometimes familial.
oral candidiasis thrush.
vaginal candidiasis , vulvovaginal candidiasis candidal infection of the vagina, and usually also the vulva, commonly characterized by pruritus, creamy white discharge, vulvar erythema and swelling, and dyspareunia.
can·di·di·a·sis (k n d -d   -ss) or can·di·do·sis (-d ss)n. A fungous infection caused by a species of Candida, especially Candida albicans, that can involve various parts of the body, such as the skin and mucous membranes. Also called moniliasis. |
candidiasis
[kan′didī′əsis]
Etymology: L, candidus + Gk, osis, condition
any infection caused by a species of Candida, usually Candida albicans. The nails, rectum, and skin folds are sites of infection. Diaper rash, intertrigo, vaginitis, conjunctivitis, and thrush are common topical manifestations of candidiasis. Oral candidiasis without a history of recent antibiotic therapy, cytoxic therapy, corticosteroid therapy, radiation therapy to the head and neck, or immunosuppressive disorder may indicate the possibility of human immunodeficiency virus infection. The most common source for candidemia is the GI tract and intravascular catheters. Also called candidosis , moniliasis.
observations This common form of vaginitis presents with a thick, cheesy white or yellow discharge; intense itching, and redness and swelling of labia and vulva. Symptoms exacerbate in the week that precedes menses, and menstruation provides some relief of the itching. Diagnosis is based on symptomatology and positive wet mount or culture.
interventions Treatment targets the infective agent with the use of topical and/or oral antifungal agents.
nursing considerations Instruction in correct use of vaginal applications of medications is needed. Stress should be placed on the need to complete the full course of antifungal treatment. Education should include the importance of vaginal hygiene/cleanliness to prevent an environment for pathogen growth. Douching should be avoided, because it destroys the protective vaginal environment. Tight, nonporous, nonabsorbent underclothing should be avoided.
candidiasis [kan″dĭ-di´ah-sis]
infection by fungi of the genus Candida, generally C. albicans, most commonly involving the skin, oral mucosa (thrush), respiratory tract, or vagina; occasionally there is a systemic infection or endocarditis. It is most often associated with pregnancy, glycosuria, diabetes mellitus, or use of antibiotics. The Centers for Disease Control and Prevention has found that in the United States this condition is the fourth most common cause of nosocomial infections of the blood stream. Called also candidosis and moniliasis.
The most prominent symptom of vaginitis due to Candida infection is severe itching. Sexual transmission is unlikely. Intravaginal cream containing miconazole or clotrimazole, applied each night for one week, usually clears up the infection. Difficulty or pain with swallowing, or retrosternal pain, may indicate candidiasis of the esophagus. Systemic antifungal therapy is indicated for esophagitis and other more severe forms of the disease. Therapeutic options include ketoconazole, fluconazole, and amphotericin b. Chronic suppressive therapy is sometimes required for severely immunocompromised patients. The Infectious Disease Society of America has published “Practice Guidelines for the Treatment of Candidiasis” on their web site, http://www.idsociety.org.
The most prominent symptom of vaginitis due to Candida infection is severe itching. Sexual transmission is unlikely. Intravaginal cream containing miconazole or clotrimazole, applied each night for one week, usually clears up the infection. Difficulty or pain with swallowing, or retrosternal pain, may indicate candidiasis of the esophagus. Systemic antifungal therapy is indicated for esophagitis and other more severe forms of the disease. Therapeutic options include ketoconazole, fluconazole, and amphotericin b. Chronic suppressive therapy is sometimes required for severely immunocompromised patients. The Infectious Disease Society of America has published “Practice Guidelines for the Treatment of Candidiasis” on their web site, http://www.idsociety.org.
atrophic candidiasis oral candidiasis marked by erythematous, pebbled patches on the hard or soft palate, buccal mucosa, and dorsal surface of the tongue, a complication of numerous different conditions such as vitamin deficiency, diabetes mellitus, or poorly fitting dentures. There are acute forms and a chronic form called denture stomatitis.
bronchopulmonary candidiasis candidiasis of the respiratory tree, occurring in a mild afebrile form manifested as chronic bronchitis, and in a usually fatal form resembling tuberculosis. Called also bronchocandidiasis.
chronic mucocutaneous candidiasis a group comprising a number of varying forms of Candida infection, marked by chronic candidiasis of the skin and nails and the mucous membranes of the mouth and vagina that is resistant to treatment; it may be localized or diffuse, is sometimes familial, and may be associated with disorders of the immune and endocrine systems.
endocardial candidiasis Candida endocarditis.
oral candidiasis thrush.
pulmonary candidiasis a type of fungal pneumonia caused by infection with Candida species, seen especially in immunocompromised patients or those with malignancies. Called also Candida pneumonia.
vaginal candidiasis (vulvovaginal candidiasis) candidal infection of the vagina, and usually also the vulva, commonly characterized by itching, creamy white discharge, vulvar redness and swelling, and dyspareunia. Called also Candida or candidal vaginitis and Candida or candidal vulvovaginitis.
candidiasis (kan·di·dīˑ·
·sis),n overgrowth of the microscopic fungal pathogen candida, usually
Candida albicans.
Candida albicans.
)
Candidiasis.
candidiasis (kan´didī
sis),candidiasis, angular cheilitis,
n a condition that forms fissures or ulcers radiating from the corners of the oral cavity (commissures) often accompanied by white plaques. Usually observed in elderly patients, although when observed in a young person, it may be an indicator of HIV infection. Candidiasis of the esophagus, trachea, bronchi, or lungs is associated with group IV human immunodeficiency virus (HIV) infection. See also acquired immunodeficiency syndrome (AIDS).
candidiasis, erythematous (atrophic),
n a condition that forms smooth red patches on the hard or soft palate, buccal mucosa, or dorsal surface of the tongue.
candidiasis, hyperplastic,
n a condition that forms white plaques that cannot be removed by wiping or scraping.
)
Chronic hyperplastic candidiasis.
candidiasis, pseudomembranous,
n a condition that forms loosely adherent (wipeable), yellowish-white plaques on the oral mucosal surface.
candidiasis, candidosis
infection by fungi of the genus Candida, generally C. albicans. Three specific syndromes are recorded as being caused by C. albicans: (1) mycotic stomatitis of baby pigs which can spread to the lower alimentary tract and cause fatal enteritis; (2) chronic pneumonia in cattle in feedlots; (3) thrush-like lesions in the mouth of many species and esophagus, crop, proventriculus and gizzard of birds. Many other secondary infections occur, e.g. keratoconjunctivitis, stomatitis, bovine mastitis, esophagitis and ulcerative dermatitis in dogs. Candida is a common pathogen in immunosuppressed dogs or cats.
candidiasis
Moniliasis, candidosis Infectious disease Infection with Candida, especially of mucocutaneous surfaces and caused by C albicans Clinical Dysphagia, oral lesions Diagnosis Endoscopy, cytology, cultures Management
Ketoconazole, fluconazole
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