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Candidiasis

Candidiasis, commonly called yeast infection or thrush, is a fungal infection of any of the Candida species, of which Candida albicans is probably the most common. more...

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Locations

In immunocompetent people, candidiasis can usually only be found in exposed and moist parts of the body, such as:

  • the oral cavity (oral thrush)
  • the vagina (vaginal candidiasis or thrush)
  • folds of skin in the diaper area (diaper rash)
  • the most common cause of vaginal irritation or vaginitis
  • can also occur on the male genitals, particularly in uncircumcised men.

In immunocompromised patients, the Candida infection can become systemic, causing a much more serious condition, fungemia.

Causes

Yeast organisms are always present in all people, but are usually prevented from "overgrowth" (uncontrolled multiplication resulting in symptoms) by naturally occurring microorganisms.

At least three quarters of all women will experience candidiasis at some point in their lives. The Candida albicans organism is found in the vaginas of almost all women and normally causes no problems. However, when it gets out of balance with the other "normal flora," such as lactobacilli (which can also be harmed by using douches), an overgrowth and symptoms can result. Pregnancy, the use of oral contraceptives and some antibiotics, and diabetes mellitus increase the risk of infection.

Symptoms

The most common symptoms are itching and irritation of the vagina and/or vulva. A whitish or whitish-gray discharge may be present, sometimes resembling cottage cheese, and may have a "yeasty" smell like beer or baking bread.

Diagnosis

KOH (potassium hydroxide) preparation can be diagnostic. A scraping or swab of the affected area is placed on a microscope slide. A single drop of 10% solution of KOH is then placed on the slide. The KOH dissolves the skin cells but leaves the Candida untouched. When viewed under a microscope the hyphae and pseudo spores of Candida are visible. Their presence in large numbers strongly suggest a yeast infection.

Swab and culture is performed by rubbing a sterile swab on the infected skin surface. The swab is then rubbed across a culture medium. The medium is incubated for several days, during which time colonies of yeast and or bacteria develop. The characteristics of the colonies provide a presumptive diagnosis of the organism.

Treatment

Candidiasis is alleged to be successfully treated either with home remedies or, in the case of a more severe infection, with either over the counter or prescription antifungal medications. Home remedies for candidiasis include the consumption or direct application of yogurt, which contains lactobacillus ("friendly" bacteria that kill yeast), acidophilus tablets or salves, and even lightly crushed cloves of garlic, which yield allicin, an antifungal. Boric acid has also been used to treat yeast infections when gelcaps are filled with boric acid powder and two are inserted at bedtime for three to four nights.

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Candida and Candidiasis. - book review
From Emerging Infectious Diseases, 8/1/02 by Mary E. Brandt

Richard A. Calderone, editor

American Society for Microbiology Press, Washington, 2001; 472 pages.

Yeast of the genus Candida have exploded into prominence in recent years as opportunistic and nosocomial fungal pathogens. However, the most recent textbook on these organisms was written in 1988. Candida and Candidiasis is a worthy successor in providing comprehensive information on the biology of these organisms.

A total of 28 chapters cover the general properties, virulence factors, cell biology, immunity, genomics, diseases, and laboratory aspects of Candida species, with particular emphasis on its most prominent member, Candida albicans. The strongest chapters are those covering research aspects of these organisms. Complex subjects like the chemistry of the cell wall, host recognition and adherence, the cell biology of the yeast-hyphal transformation, and extracellular hydrolases as virulence factors in C. albicans are well summarized with clear, useful graphics and current references. The book is beautifully laid out, with a series of color plates that help describe phenotype switch variants and chromosome maps.

The clinical chapters appear rather superficial for an infectious diseases clinician but may be useful to a student seeking basic material. The chapter on identification and subtyping contains information available in other sources for less than the cost of this book. A discussion of current practices in antifungal susceptibility testing of Candida species would have been helpful. Chapters 2 and 4 contain repetitious material, including photographs of C. dubliniensis. A consolidated chapter on the epidemiology of Candida infections should be considered for the next edition. The chapters covering the cell biology are most useful, either as a comprehensive overview or as a reference text for researchers and students interested in the biology of these organisms.

Mary E. Brandt

Centers for Disease Control and Prevention, Atlanta, Georgia, USA

COPYRIGHT 2002 U.S. National Center for Infectious Diseases
COPYRIGHT 2002 Gale Group

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