Candidiasis

Candidiasis is an infection caused by a species of the yeast Candida,usually Candida albicans. It is a common cause of vaginal infections in women. It may also cause mouth infections in people with reduced immune function, or in patients taking certain antibiotics. A more serious form of thecondition, known as deep organ candidiasis, can infect nearly all the major organs of the body.

Over one million women in the United States develop vaginal candidiasis, morecommonly known as yeast infections, each year. Most women with vaginal candidiasis experience severe vaginal itching. They also have a discharge that often looks like cottage cheese and has a sweet or bread-like odor. The vulva and vagina can be red, swollen, and painful, particularly during sexualintercourse.

In most cases, vaginal candidiasis can be treated successfully with a varietyof over-the-counter antifungal creams or suppositories. These include Monistat, Gyne-Lotrimin, and Mycelex. However, infections often recur, and women may need to take a prescription anti-fungal drug such as terconazole (sold as Terazol) or take other anti-fungal drugs on a preventive basis.

Oral candidiasis, also known as thrush, causes white, curd-like patches on the tongue, inside of the cheeks, or the palate. Thrush typically occursin people with abnormal immune systems. These can include people undergoingchemotherapy for cancer, people taking immunosuppressive drugs to protect transplanted organs, or people with HIV infection.

Thrush is usually treated with prescription lozenges or mouth washes. Some ofthe most-used prescriptions are nystatin mouthwashes (Nilstat or Nitrostat)and clotrimazole lozenges. Good oral hygiene might reduce problems, but is not a guarantee against candidiasis.

Also known as invasive candidiasis, deep organ candidiasis is a serious infection that can affect the esophagus, heart, blood, liver, spleen, kidneys, eyes, and skin. Like vaginal and oral candidiasis, it is an opportunistic disease that strikes when a person's resistance is lowered, often due to another illness. Anything that weakens the body's natural barrier against colonizing organisms--including stomach surgery, burns, nasogastric tubes, artificial joints and valves, and catheters--can increase a patient's suceptibility to infection. Rising numbers of AIDS patients, organ transplant recipients, and otherindividuals whose immune systems are compromised help account for the dramatic increase in deep organ candidiasis in recent years. Patients with granulocytopenia (deficiency of white blood cells) are particularly at risk for deeporgan candidiasis.

Fungal blood cultures and/or tissue biopsy are usually required to diagnose deep organ candidiasis. Drug treatment is based on a patient's medical historyand immune status. If possible, catheters and nasogastric tubes should be removed from patients in whom these devices are still present and antifungal chemotherapy started to prevent the spread of the disease.

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