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Candidiasis - Symptoms (With Pictures) And Treatment

Also called candidosis and moniliasis, candidiasis is usually a mild, superficial fungal infection caused by the Candida genus. Most often, it infects the nails (onychomycosis), skin (diaper rash), or mucous membranes, especially the oropharynx (thrush), vagina (moniliasis), esophagus, and GI tract.

Rarely, these fungi enter the blood­stream and invade the kidneys, lungs, endocardium, brain, or other structures, causing serious infections. Such systemic infection is most prevalent among drug abusers and patients already hospitalized, particularly diabetics and immunosuppressed patients. The prognosis varies, depending on the patient's resistance

Causes of Candidiasis

Most cases of Candida infection result Hom C. albicans. Other infective strains include C. parapsilosis, C. tropicalis, and C. guillermondii. These fungi are part of the normal flora of the GI tract, mouth, vagina, and skin. They cause infection when some change in the body permits their sudden proliferation - rising glucose levels Hom diabetes mellitus; lowered resistance Hom a disease (such as cancer), an immunosuppressant drug, radiation, aging, or human immunodeficiency virus (HIV) infection; or when they're introduced systemically by LV. or urinary catheters, drug abuse, hyperalimentation, or surgery.

However, the most common predisposing factor remains the use of broad­spectrum antibiotics, which decrease the number of normal flora and permit an increasing number of candidal organisms to proliferate. The infant of a mother with vaginal moniliasis can contract oral thrush while passing through the birth canal. The incidence of candidiasis is rising because of wider use of LV. therapy and a greater number of immuno­compromised patients, especially those with HIV infection

Signs and symptoms of Candidiasis

Superficial candidiasis produces symp­toms that correspond to the foIlowing sites of infection:

• skin: scaly, erythematous, papular rash, sometimes covered with exudate, appearing below the breast, between the fingers, and at the axillae, groin, and umbilicus (In diaper rash, papules appear at the edges of the rash.)
• nails: red, swoIlen, darkened nailbed; occasionaIly, purulent discharge and the separation of a pruritic nail from the nailbed
• oropharyngeal mucosa (thrush): cream-colored or bluish white patches of exudate on the tongue, mouth, or pharynx that reveal bloody engorgement when scraped. They may swell, causing respiratory distress in infants. They're only occasionaIly painful but cause a burning sensation in the throats and mouths of adults.
• esophageal mucosa: dysphagia, retrosternal pain, regurgitation and, occasionaIly, scales in the mouth and throat
• vaginal mucosa: white or yellow discharge, with pruritus and local excoriation; white or gray raised patches on vaginal waIls, with local inflammation; dyspareunia.

Systemic infection produces chills; high, spiking fever; hypotension; prostration; and occasional rash. Specific symptoms depend on the site of infection, as follows:

• pulmonary system: hemoptysis, fever, cough
• renal system: fever, flank pain, dysuria, hematuria, pyuria
• brain: headache, nuchal rigidity, seizures, focal neurologic deficits
• endocardIum: systolic or diastolic murmur, fever, chest pain, embolic phenomena
• eye: endophthalmitis, blurred vision, orbital or periorbital pain, scotoma, exudate.

Diagnosis

Treatment of Candidiasis

The first aim of treatment is to improve the underlying condition that predisposes the patient to candidiasis, such as controlling diabetes or discontinuing antibiotic therapy and catheterization, if possible.

Nystatin is an effective antifungal for superficial candidiasis. Clotrimazole, fluconazole, ketoconazole, and miconazole are effective in mucous membrane and vaginal Candida infections.

Ketoconazole or fluconazole is the treatment of choice for chronic candidiasis of the mucous membranes. Treatment for systemic infection consists of LV. amphotericin B with or without 5-fluorocytosine.

Herbal home remedies for Candidiasis

• 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.
• Wear sandals or leather shoes instead of trainers.
• he following grains help to inhibit Candida growth: millet, roasted buckwheat (kasha), rye, oats, barley, amaranth, and quinoa . Grains should be chewed thoroughly and not overeaten.
• Wear clothes that are made of cotton or wool. These will allow the skin to breathe and rid itself of surplus moisture. Change clothes and socks regularly so that you are always wearing dry ones.
• Aloe, fresh juice is used to boost white blood cells which kill yeast cells.
• An omega-3 rich Essential Fatty Acid supplement such as flaxseed oil or capsules may be of value as it can help to reduce inflammation.

Special considerations and 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.

• Instruct a patient using nystatin solution to swish it around in his mouth for several minutes before he swallows the solution.
• Swab nystatin on the oral mucosa of an infant with thrush.
• Provide the patient with a nonirritating mouthwash to loosen tenacious secretions and a soft toothbrush to avoid irritation.