This is a fungal infection caused by Candida spp. {a type of yeast}. There are more than 20 types of Candida specie with Candida albicans being the most common. About three-quarters of women have at least one yeast infection at some time during their lives. Oral candidiasis is the most common fungal infection of the mouth. It is also the most common opportunistic oral infection in human.

Candidiasis typically affects warm parts of the body such as;

  • Vagina
  • Mouth
  • Throat
  • Nail
  • Diaper region in babies
  • Folds under the breast                                                                                                                                            Invasive candidiasis affects the blood, brain, heart and eyes.

RISK FACTORS

Candida spp is a normal flora of the human body but the immune system of the body keeps its growth in check. Certain factors can increase ones chances of having an overwhelming growth of the fungi. They are;

1] *Recent use of antibiotics; this kills the body’s natural competitor of candida thereby increasing the growth rate of the organism.

2] Reduced immunity in conditions such as;

  • Recent prolonged sickness;
  • HIV
  • Chemotherapy
  • Old age
  • Diabetes
  • Steroid use
  • Use of immunosuppressive drugs; after organ transplant.
  • In children less than a month

3] Recent dentures

4] After sexual intercourse {usually for penile candidiasis} especially with an infected woman.

5] Poor sanitary practice and excessive douching; this has been found to increase the chances of having vaginal candidiasis.

6] Infrequent change of diapers in babies; prolonged exposure of a baby’s skin to urine and faeces increases the risk of having diaper candidiasis. The use of moist cloth nappies can also predispose to candidiasis.

SIGNS AND SYMPTOMS

Signs and symptoms of candidiasis are dependent on the affected part of the body.

Vaginal candidiasis presents with burning and itching sensation around the vagina. There can also be multiple sores around the vestibule with associated copious whitish or whitish-gray cottage cheese-like discharge.

Esophageal candidiasis; symptoms include difficulty swallowing, painful swallowing, abdominal pain, nausea, and vomiting.

Infection of the male genitalia (balanitis thrush) symptoms include red skin around the head of the penis, swelling, irritation, itchiness and soreness of the head of the penis. There can also be thick, lumpy discharge under the foreskin, unpleasant odour, difficulty retracting the foreskin (phimosis), and pain when passing urine or during sex.

Gastrointestinal candidiasis; symptoms in healthy individuals are anal itching, belching, bloating, indigestion, nausea, diarrhea, gas, intestinal cramps, vomiting, and gastric ulcers

Candidiasis in babies; babies with oral candidiasis have a white patch on the tongue and in the oral cavity which is not easily removable with spoon or tongue spatula. In diaper candidiasis, they can have rash which are raised with associated red infected bump (satellite pustules) around the rash in the nappy region. The skin folds of the diaper region are mostly affected.

 

PREVENTION

It is important to wear cotton instead of nylon underwear as this reduces the risk of developing skin and vaginal yeast infections.

Avoid wearing wet clothes and underwear.

Proper sanitary hygiene and regular change of sanitary pads can help reduce the chances of having vaginal candidiasis

Avoid vaginal douching because the vagina in a self-cleaning organ.

For people undergoing cancer treatment, chlorhexidine mouthwash can prevent or reduce oral candidiasis infection.

Prompt mouthwash after use of oral steroids can help reduce the chances of having oral candidiasis.

Regular consumption of yoghurt can help reduce the chances of having candida infection as it contains lactobacillus which is a natural competitor of  Candida spp.

Avoid use of wet diaper for your child.

Prompt change of soiled or soaked diaper.

Use of barrier creams such as vaseline to diaper area after bathing the child.

TREATMENT

It is important to seek medical help once any of the symptoms of candidiasis is noticed. Delay in treatment can lead to invasive candidiasis which can lead to death in 19-24% of those affected.

Topical antifungal creams such as miconazole and ketoconazole creams can be used for oral, diaper and vaginal candidiasis.

Vaginal pessaries can also be used for treatment of vaginal candidiasis.

Systemic {oral and intravenous} antifungal drugs are used for more severe infections.