What Is Candida and Candidiasis?

A Fungus Can Overgrow Inside The Body, Causing Infection

Microscopic image of thrush infection of candidiasis
A close-up view of an overgrowth of Candida albicans in the mouth that caused oral thrush.. Image © BSIP/UIG / Getty Images

What Is Candida and Candidiasis?

Candida is a type of fungus that naturally occurs in small amounts on the skin and in the mouth, the intestines, and the vagina. The most common of the Candida species is Candida albicans (KAN-did-uh AL-bi-kanz).

Candida does not normally cause disease unless some kind of circumstance causes the fungus to multiply and the colony will grow. This causes an infection which may require treatment in order to get it under control.

For example, Candida could overgrow after a person takes a course of antibiotics for a bacterial infection (such as for a urinary tract infection or pneumonia), or because the immune system is depressed due to disease, or as a side effect of some medications. Candida overgrowth is called candidiasis.

Fortunately there are many effective treatments to treat a Candida infection. In many cases, people who are at risk of developing this type of infection are already under the supervision of a physician, and may be closely watched for this complication. In some situations, preventive treatment might be offered in order to prevent a fungal infection from occurring. In the case of an infection that occurs unexpectedly, a primary care physician or a dermatologist can make the diagnosis and help develop a treatment plan.

Conditions Caused By Candida Overgrowth

An overgrowth of Candida in the mouth is called thrush.

Thrush is more common in infants and in people who have diabetes or are HIV positive.

Candida overgrowth in the vagina is commonly called a vaginal yeast infection or vaginitis. Many women experience a yeast infection at some point during their lives, and vaginal candidiasis is more common during pregnancy.

Some women find that after taking a course of antibiotics to treat a simple infection, a yeast infection can occur almost directly after.

Candidiasis on the skin (called cutaneous candidiasis) tends to occur most often in warm, moist areas such as the groin (can occur with a diaper rash in babies) and under the breasts. The nails can also be infected (called candidal paronychia), typically because of chronic exposure to water or after a manicure or pedicure that is done with tools that are not sterile.

A more serious form of candida infection in the bloodstream or internal organs is invasive candidiasis. Invasive candidiasis is rarer, and tends to occur in patients who are already very sick, such as those who have had an organ transplant or those who are in intensive care units. This form of candidiasis can be fatal.

Treating Candidiasis

Treatment of candidiasis normally includes antifungal medications, either taken by mouth or applied topically. Some of the most commonly prescribed antifungals include Diflucan (fluconazole) and the echinocandins: Mycamine (micafungin), Cancidas (caspofungin), and Mycamine (micafungin).

If these treatments are ineffective, or if the infection is throughout the body, other antifungal treatments such as Sporanox (itraconazole) might be used.

Polyene antifungals, including amphotericin B (Ambisome and Amphotec) and Nystatin (Nyamyc, Pedi-Dri, and Nystop) may be used to treat fungal infections that are associated with HIV.

The azole medication Nizoral (ketoconazole) is not prescribed as frequently because the newer azoles have been found to be more tolerable for patients. Two more azoles that are not used very commonly include VFend (voriconazole) and Posanol (posaconazole).

For uncomplicated yeast infections, over-the-counter remedies are available, but should only be used on the advice of a physician, because these treatments don't always fully clear up the infection.

For diaper rash or other forms of skin infections, keeping the area dry and clean is also helpful. Long-term antifungal therapy may be needed to treat chronic candidiasis. 

Sources:

American Academy of Dermatology. Diaper rash: How to treat. AAD.org. 2016.

Lionakis MS, Edwards L. Vaginal yeast infection. WomensHealth.gov Jan 6, 2015.

Martins N, Ferreira IC, Barros L, Silva S, Henriques M. Candidiasis: predisposing factors, prevention, diagnosis and alternative treatmentMycopathologia. 2014 Jun;177:223-240.

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