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Candida information

Candida is a type of yeast (a type of fungus). Some types are harmless and some types cause infections. Candida infections range from the superficial and common – such as candidiasis or thrush – to systemic and potentially life-threatening diseases which are usually confined to severely immunocompromised persons, such as cancer, transplant, and AIDS patients.

What causes candida?

There are more than 20 species of candida, the most common being candida albicans. These fungi live on all surfaces of our bodies. Under certain conditions, they can become so numerous they cause infections, particularly in warm and moist areas. Types of infections caused by candida include vaginal yeast infections, thrush (infection of tissues of the oral cavity), skin and nappy rash, and nailbed infections.

Vaginal yeast infection, which is the most common form of vaginitis, is often referred to as vaginal candidiasis.

In adults, oral yeast infections become more common with increased age. Adults can also have yeast infections around dentures, in skin folds under the breast and lower abdomen, nailbeds, and beneath other skin folds.

The most common forms of candida infections to affect children include nappy rash and oral thrush, although young girls can also suffer from vaginal candidiasis.

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 candida also can grow in the lungs, liver, and spleen. Candida is a leading cause of esophagitis (infection in the swallowing tube) in people with AIDS.

What are the signs and symptoms of candida?

The signs and symptoms of a candidal infection can vary depending on the location of the infection.

Common symptoms of a vaginal yeast infection include a white discharge that is thick and often described as having a cottage cheese appearance.

The infection can also cause itching and irritation inside the vagina and surrounding the outer tissues. On occasion there may be pain with sexual intercourse or burning with urination (pee).

Oral candidiasis is called thrush. Typical symptoms include:

• thick, white lacy patches on top of a red base can form on the tongue, palate, or elsewhere inside the mouth
• red tongue
• pain
• difficulty eating

Superficial candidal skin infections (and nappy rash) appear as a red flat rash with sharp scalloped edges. There are usually smaller patches of similar appearing rash nearby, known as ‘satellite lesions’. These rashes may cause itching or pain.

In people with weakened immune systems, candidal infections can affect various internal organs and cause pain or dysfunction of the organ.

If candida gets into the bloodstream, the person may become sick with or without fever. If the infection spreads to the brain, they may have acute changes in mental function or behaviour.

How is candida normally diagnosed?

For healthy people (those without weakened immune systems), most GPs can diagnose a candidal infection by asking about symptoms and on physical examination of the area affected.

Occasionally, if the infection won't go away or involves the entire body, more extensive tests may need to be performed.

Oral thrush is diagnosed with an examination of the mouth and nappy rash diagnosed with an examination of the skin around the anus.

If there is any confusion about the diagnosis, the GP may obtain a small scraping of the area to be examined in a laboratory.

In people with weakened immune systems, oral, vaginal, and skin candidal infections can also usually be diagnosed by sight.

How is candida normally treated?

Most candidal infections can be treated at home with over-the-counter or prescription medications and can clear within a week. If it is a first candidal infection, or if the infection is in a child, the advice of a GP should be sought.,

Vaginal thrush can be treated with antifungal cream, tablets and/or pessaries (which are inserted inside the vagina). Usually a child can be treated with cream alone. Ask a pharmacist for advice on which creams are available.

Skin rashes and nappy rash can also be treated with cream alone. For nappy rashes, frequent nappy changes and the use of barrier creams will speed recovery.

Oral thrush is usually treated with a mouthwash containing an antifungal agent called nystatin.

If symptoms are recurrent or continue for more than one week, a GP should be consulted.

If a child has a weakened immune system due to any medical treatment for an underlying illness, you should speak to a doctor about any candidal infection. In some cases the infection can affect other parts of their body making them very ill. A doctor will want to monitor their treatment.

What happens next?

With proper treatment, most candidal infections resolve without further problems. Vaginal yeast infections, thrush, and nappy rash usually clear in one to two weeks. In people with weakened immune systems , these infections can recur and become difficult to treat.