The most common type of candidiasis is a superficial infection of the mouth, vagina, or skin that causes white or red patches and itching, irritation, or both.
People whose immune system is weakened may have serious infections of the esophagus and other internal organs.
A sample of infected material is examined under a microscope and sent for culture.
Antifungal drugs may be applied directly to the affected area or taken by mouth, but serious infections require drugs given by vein.
Candida is normally present on the skin, in the intestinal tract, and, in women, in the genital area. Usually, Candida in these areas does not cause problems. However, the fungi sometimes cause skin infections Candidiasis (Yeast Infection) Candidiasis is infection with the yeast Candida. Candidiasis tends to occur in moist areas of the skin. Candidiasis may cause rashes, scaling, itching, and swelling. Doctors examine the... read more 
, mouth infections Symptoms (affecting the mucous membranes), or infections of the vagina Overview of Vaginitis (Vaginal Infection or Inflammation) Vaginal infections are one of the most common reasons women see their doctor, accounting for millions of visits each year. Vaginal infections are caused by infectious organisms (such as bacteria... read more . Such infections can develop in people with a healthy immune system, but they are more common or persistent in people with diabetes, cancer, or AIDS and in pregnant women. Candidiasis of the mouth and esophagus are common among people with AIDS. Candidiasis is also common among people who are taking antibiotics because the antibiotics kill the bacteria that normally live in the body and compete with Candida, allowing Candida to grow unchecked.
Candidiasis is bothersome but rarely life threatening. However, some forms of candidiasis are serious. They include
Invasive candidiasis
Candidemia (the most common form of invasive candidiasis)
(See also Overview of Fungal Infections Overview of Fungal Infections Fungi are neither plants nor animals. They were once thought to be plants but are now classified as their own kingdom. Some fungi cause infections in people. Because fungal spores are often... read more , Candidiasis Candidiasis (Yeast Infection) Candidiasis is infection with the yeast Candida. Candidiasis tends to occur in moist areas of the skin. Candidiasis may cause rashes, scaling, itching, and swelling. Doctors examine the... read more of the skin, and Vaginal Yeast Infection Vaginal Yeast Infection (Candidiasis) A vaginal yeast infection (also called candidiasis) is caused by an infectious organism called Candida, usually Candida albicans. A vaginal yeast infection may cause intense itching... read more .)
In invasive candidiasis, the infection spreads to other parts of the body, such as the heart valves, brain, spleen, kidneys, and eyes. Invasive candidiasis occurs mainly in people with a weakened immune system and in hospitalized people. Candidiasis is one of the most common infections acquired in the hospital.
Candidiasis of the esophagus is one of the illnesses indicating that HIV infection has developed into AIDS Acquired immunodeficiency syndrome (AIDS) Human immunodeficiency virus (HIV) infection is a viral infection that progressively destroys certain white blood cells and is treated with antiretroviral medications. If untreated, it can cause... read more 
(called an AIDS-defining illness).
Candidemia is a serious infection of the bloodstream. In the United States, Candida is a common cause of bloodstream infections. The risk of developing this infection is increased by certain conditions, such as the following:
Major surgery
Use of intravenous lines or tubes—particularly a tube inserted into one of the large veins of the neck, upper chest, or groin (central venous catheter) or a tube used to provide nutrition (intravenous feeding Intravenous Feeding Intravenous feeding is used when the digestive tract cannot adequately absorb nutrients, as occurs in severe malabsorption disorders. It is also used when the digestive tract must be temporarily... read more )
Use of certain antibiotics
Candidemia is often fatal if not promptly treated.
Symptoms of Candidiasis
Infection of the mouth (thrush) causes the following:
Creamy, white, painful patches inside the mouth
Cracking at the corners of the mouth (cheilitis)
A red, painful, smooth tongue
In candidiasis of the mouth, white, painful patches form in the mouth—for example, under dentures (top photo) or on the tongue (bottom photo).
Images courtesy of Jonathan Ship, MD.
In candidiasis of the mouth, white, painful patches may form on the inside of the lips.
© Springer Science+Business Media
In candidiasis of the mouth, white, painful patches may form on the tongue.
© Springer Science+Business Media
Patches in the esophagus cause pain or difficulty swallowing.
When the skin is infected, a burning rash develops. Some types of diaper rash Diaper rash (diaper dermatitis) A rash is an abnormal change in the texture or color of the skin. Known causes of rashes include irritation, allergies, drugs, and bacterial, fungal, or viral infections. Rashes include redness... read more 
are caused by Candida.
If the infection spreads to other parts of the body, it is more serious. It can cause fever, a heart murmur, enlargement of the spleen, dangerously low blood pressure (shock Shock Shock is a life-threatening condition in which blood flow to the organs is low, decreasing delivery of oxygen and thus causing organ damage and sometimes death. Blood pressure is usually low... read more ), and decreased urine production. An infection of the retina and inner parts of the eye can cause blindness. If the infection is severe, several organs may stop functioning, and death can occur.
Diagnosis of Candidiasis
Examination and sometimes culture of a sample of blood or infected tissue
Sometimes blood tests
Many candidal infections are apparent from the symptoms alone.
To confirm the diagnosis, a doctor must identify the fungi in a sample viewed under a microscope. Samples of blood or other infected tissues may be sent to a laboratory to be cultured and examined to identify the fungi.
Doctors may do a blood test called the T2Candida® Panel to detect Candida in the blood quickly and accurately. Other tests that detect genetic material in microorganisms Tests That Detect Genetic Material in Microorganisms Infectious diseases are caused by microorganisms, such as bacteria, viruses, fungi, and parasites. Doctors suspect an infection based on the person's symptoms, physical examination results,... read more may be done, including polymerase chain reaction (PCR). The PCR test is used to produce many copies of a gene from a microorganism, making the microorganism much easier to identify.
If candidemia is diagnosed, doctors may examine the eyes to determine whether the eyes are infected.
Treatment of Candidiasis
Antifungal drugs
Candidiasis that occurs only on the skin or in the mouth or vagina can be treated with antifungal drugs (such as clotrimazole and nystatin) that are applied directly to the affected area. A doctor may also prescribe the antifungal drug fluconazole to be taken by mouth.
For infections of the esophagus, doctors prescribe antifungal drugs (such as fluconazole or itraconazole) to be taken by mouth. If these drugs are ineffective or if the infection is severe, other antifungal drugs are used. Choices include anidulafungin, caspofungin, micafungin, or amphotericin B given by vein (intravenously), voriconazole given by mouth or vein, isavuconazole given by mouth, and posaconazole given by mouth.
Candidiasis that has spread throughout the body is usually treated with anidulafungin, caspofungin, or micafungin given intravenously or with fluconazole, which can be given intravenously or by mouth.
Candidiasis is more serious and less responsive to treatment in people with certain disorders, such as diabetes. In people with diabetes, controlling blood sugar levels facilitates cure of the infection.
Drugs Mentioned In This Article
| Generic Name | Select Brand Names |
|---|---|
clotrimazole |
Alevazol , Antifungal, Anti-Fungal, Cruex, Desenex, Fungoid, Gyne-Lotrimin, Lotrimin, Lotrimin AF, Lotrimin AF Ringworm, Micotrin AC, Mycelex, Mycelex Troche, Mycozyl AC |
fluconazole |
Diflucan |
anidulafungin |
Eraxis |
amphotericin b |
Amphocin, Fungizone |
voriconazole |
VFEND |
posaconazole |
Noxafil |
caspofungin |
Cancidas |
micafungin |
Mycamine |
