Candidiasis (yeast infection)


 

Also called thrush, this common infection affects many women whether they are sexually active or not. Candida is a yeast or fungus that is commonly present in the bowel and vagina, and less commonly inside the mouth. Problems arise if the yeast multiplies, especially in the vagina, where it causes a white and sometimes curd-like discharge as well as intense itching or burning. Candida thrives well in damp places, especially if the skin is broken or sugar levels in the blood are high.

 

How does Candidiasis develop?

Normally, a healthy bacteria called lactobacillus is present in the vagina and keeps the unwelcome candida at bay. However, if the balance between these is upset, yeast may develop. This can happen after taking antibiotics, which may destroy many of the normal bacteria, as well as unhealthy bacteria, and this allows candida to multiply. Women with diabetes often develop thrush because of the high sugar levels in their urine and vaginal secretions. This may also be why some women are prone to thrush after consuming a lot of sweet foods or alcoholic drinks.

 

In people who have a weakened immune system because of cancer treatments, steroids, or diseases such as AIDS, candidal infections can occur throughout the entire body and can be life-threatening. The blood, brain, eye, kidney, and heart are most frequently affected, but the candidal fungus also can grow in the lungs, liver, and spleen. Candida is the leading cause of esophagitis (inflammation in the throat) in people with AIDS

 

What are the symptoms of candidiasis?

The symptoms of candidiasis vary depending on the location of the infection. The following are the most common symptoms of a yeast infection. However, each individual may experience symptoms differently. Symptoms may include:

 

Location

Symptoms

skin folds or navel

  • rash

  • patches that ooze clear fluid

  • pimples

  • itching or burning

vagina

  • white or yellow discharge from the vagina

  • itching

  • redness in the external area of the vagina

  • burning

mouth (thrush)

  • white patches on tongue and inside of the cheeks

  • pain

corners of the mouth (perlèche)

  • cracks and/or tiny cuts at the corners of the mouth

nail beds

  • swelling

  • pain

  • pus

  • white or yellow nail that separates from the nail bed

 

The symptoms of candidiasis may resemble other skin conditions. Always consult your physician for a diagnosis.

 

 

How is candidiasis diagnosed?

In addition to a medical history and physical examination, your physician may scrape off a skin sample to confirm the diagnosis with a microscope or a culture.

 

For the microscope method, a scraping or swab of the affected area is placed on a microscope slide. A single drop of 10% potassium hydroxide (KOH) solution is then also placed on the slide. The KOH dissolves the skin cells but leaves the Candida untouched, so that when the slide is viewed under a microscope, the hyphae and pseudo spores of Candida are visible. Their presence in large numbers strongly suggests a yeast infection.

 

For the culturing method, a sterile swab is rubbed 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 causing symptoms.


The effect on your fertility

Although candidiasis will probably not affect your fertility, it is important to clear up any infection during pregnancy, as your baby may catch the infection from the birth canal during delivery. A baby born with candidiasis can develop diaper rash and a sore mouth, which may lead to feeding difficulties. Thrush is very common in pregnancy (affecting about one in four women) because a pregnant woman’s vaginal secretions favor the growth of yeast. Men may get soreness or itching of the penis from candida but are often not affected. As candida is not sexually transmitted, your partner will only need treatment if you are having problems with recurrent thrush or if he has discomfort.

Treatment and Care

Specific treatment for candidiasis will be determined by your physician based on:

  • your age, overall health, and medical history

  • extent of the condition

  • your tolerance for specific medications, procedures, or therapies

  • expectations for the course of the condition

  • your opinion or preference

Modern antifungal treatments are usually very effective at curing an attack of thrush. Most antifungals, such as clotrimazole, can be given as a vaginal suppository and are safe during the preconception period. New oral antifungals are now available, but these are often not necessary, and as a rule they should be avoided in pregnancy because they have not been proven to be safe for the baby. An antifungal cream may help your symptoms for a few days but it will not get rid of the large reservoir of yeast present in the vagina.

 

Lactobacillus is present in live yogurt, so for immediate treatment, try soaking a tampon in live yogurt and inserting one into your vagina twice a day for a few days. An experiment showed that women who ate 8 ounces (225 gm) of live yogurt a day reduced their risk of getting the infection by two-thirds.

 

Garlic has also been shown to help prevent thrush in babies and women. It can be inserted into the vagina of a woman, although it may be more effective if taken orally. You can take garlic capsules or eat it fresh, but capsules are less odorous! Allicin is the active ingredient and is also present in onions.

 

Candida likes a moist, warm place to grow so avoid wearing tight jeans, synthetic underwear, or panty liners unnecessarily. It also grows well in damaged skin so it’s best to refrain from using perfumed soap, bubble bath, vaginal deodorant, and douches.

 

You should also try to limit your intake of very sweet foods and drinks, including alcohol.


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