Candidiasis

OVERVIEW

A yeast infection results from an overgrowth of yeast (a type of fungus) anywhere in the body. Candidiasis is by far the most common type of yeast infection. There are more than 20 species of Candida, the most common being Candida albicans. These fungi live on all surfaces of our bodies. Under certain conditions, they can become so numerous they cause infections, particularly in warm and moist areas. Examples of such infections are vaginal yeast infections, thrush (infection of tissues of the oral cavity), skin, including diaper rash, beneath large breasts, and nailbed infections.

CANDIDIASIS A YEAST INFECTION

Candidiasis is a fungal infection due to any type of Candida (a type of yeast). When it affects the mouth, it is commonly called thrush. Signs and symptoms include white patches on the tongue or other areas of the mouth and throat. Other symptoms may include soreness and problems swallowing. When it affects the vagina, it is commonly called a yeast infection. Signs and symptoms include genital itching, burning, and sometimes a white "cottage cheese-like" discharge from the vagina. Less commonly the penis may be affected, resulting in itchiness. Very rarely, the infection may become invasive spreading throughout the body, resulting in fevers along with other symptoms depending on the parts of the body affected.

Vaginal yeast infection, alternately referred to as vaginal Candidiasis or vulvovaginal Candidiasis (VVC), is a common fungal infection of the genitals causing inflammation, irritation, itching and vaginal discharge.

Vaginal yeast infections are experienced by as many as 3 out of 4 women during their lifetime, with most women experiencing at least two or more infections.

WHAT IS A YEAST INFECTION?

Common yeast infections are caused by the yeast species Candida albicans. However, there are other species of Candida, which can cause an infection and may at times require different treatments.

CAUSES OF A YEAST INFECTION

Balanced levels of yeast and bacteria are normally present in a woman's vagina however disturbances in this harmonious balance can lead to the development of an infection.

Candidiasis is a Yeast infections that is caused by the yeast species called Candida albicans.

Normally, the bacteria Lactobacillus can produce an environment not conducive to yeast overgrowth. However, at times, yeast will become dominant and cause symptoms of a yeast infection.

Yeast infections of the vagina are not sexually transmitted diseases, however, it can be spread through oral-genital contact or during intercourse.

There are certain risk factors that predispose a woman to a vaginal yeast infection and include:

• Use of antibiotics and or corticosteroids
• Pregnancy
• Uncontrolled diabetes
• Being immunocompromised
• Any scenarios that can cause changes in normal vaginal flora including douching.

SYMPTOMS OF A YEAST INFECTION

Signs and symptoms of candidiasis vary depending on the area affected. Most candidal infections result in minimal complications such as redness, itching, and discomfort, though complications may be severe or even fatal if left untreated in certain populations. In immunocompetent persons, candidiasis is usually a very localized infection of the skin or mucosal membranes, including the oral cavity (thrush), the pharynx or esophagus, the gastrointestinal tract, the rectum, anus, perianal/perirectal or ano-rectal area (in men as well as women), the perineum, the urinary bladder, the fingernails or toenails (onychomycosis), and the genitalia (vagina, penis,

Symptoms of a vulvovaginal yeast infection include:

Frequent symptoms of vaginal yeast infection include itching, burning and large or small amounts of vaginal discharge, often whitish gray and thick.

• Vaginal and vulvar itching or irritation
• Vaginal burning, pain, soreness
• Vaginal burning with intercourse or urination
• Vaginal discharge resembling cottage cheese (thick and white) that is odorless.

Some women may experience a complicated yeast infection, which includes more severe symptoms and includes the presence of four or more infections in a single year.

Symptoms of a complicated yeast infection include severe redness, swelling and itching, that results in skin fissures or sores.

There are certain medical conditions that cause a complicated yeast infection and include pregnancy, uncontrolled diabetes, being immunocompromised and the presence of an alternate Candida fungus as opposed to Candida albicans.

TESTS AND DIAGNOSIS OF A YEAST INFECTION

When diagnosing the presence of a vaginal yeast infection, your health care provider will obtain a medical history, perform a pelvic exam to visualize the vulva, vagina and cervix for signs of infection and at times, a sample of vaginal discharge will be tested.

A swab of vaginal discharge may be evaluated under a microscope to determine if there is an abundance of yeast present. Once it is determined if there is the presence of an uncomplicated or complicated yeast infection, treatment will be recommended.

TREATMENTS FOR A YEAST INFECTION

Uncomplicated yeast infections can be treated with one of two methods - direct vaginal therapy or oral treatment.

When treating with short-course vaginal therapy, varying methods of application may be recommended and range from a one-time treatment of a 1-7 day prescription or over-the-counter regimen by using medications such as butoconazole (Gynazole-1), clotrimazole (Gyne-Lotrimin), miconazole (Monistat 3) and terconazole (Terazol 3). Since these medications are oil based, they can weaken latex condoms and diaphragms altering their efficacy.

Alternately, an oral antifungal, fluconazole (Diflucan), can be used in one single dose.

When yeast infections are classified as complicated, treatment will change and include the use of long-course vaginal therapy or multi-dose oral formulations. At times, maintenance medications may be recommended.

Long-course vaginal therapy includes treatment with a vaginal cream, ointment, tablet or suppository for approximately 7-14 days. Alternately, two to three doses of oral fluconazole may be recommended instead of direct vaginal therapy.

Certain situations warrant treatment with maintenance medications, which begin after one of the above methods of treatment is completed and may include weekly treatment with oral fluconazole for 6 months or treatment with vaginal clotrimazole weekly. 

If your sex partner is symptomatic of yeast, it may be recommended that they too undergo treatment. The use of condoms may also be recommended.

 

There are alternative therapies that are at times used to treat vaginal yeast and include the use of prescription boric acid vaginal suppositories and the use of oral/vaginal application of yogurt. Yogurt therapy is anecdotal and currently unproven, yet may be effective in providing relief of Candida symptoms and can possibly reduce the presence of yeast.

It is important to be sure that the symptoms you are experiencing are in fact a yeast infection because the overuse of antifungals can increase the changes of yeast resistance, which means that the medications may not work in the future.

PREVENTION

While there is no guaranteed way to prevent a Candida infection, there are certain things you can do to reduce your risk of developing a vaginal yeast infection and include not douching, wearing cotton underwear, wearing loose fitting pants or skirts, avoiding tight underwear and pantyhose, promptly changing of wet articles of clothing and avoidance of hot tubs and hot baths.

Oral or intravaginal probiotics may be recommended in cases where a woman has more than three yeast infections annually.

If you think that you may be experiencing a yeast infection and are displaying concerning symptoms, it is important to speak with your health care provider for an accurate diagnosis.