What is a Yeast Infection?

Candidiasis is an infection caused by a group of microscopic fungi or yeast. 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. Examples of such infections are vaginal yeast infections, thrush, skin and diaper rash, and nailbed infections.


Candidal infections commonly occur in warm moist body areas, such as underarms. Usually your skin effectively blocks yeast, but any breakdown or cuts in the skin may allow this organism to penetrate.

Typical affected areas in babies include the mouth and diaper areas.

In adults, oral yeast infections become more common with increased age. Adults also can have yeast infections around dentures, under the breast and lower abdomen, nailbeds, and beneath other skin folds. Most of these candidal infections are superficial and clear up easily with treatment.

Rarely, the yeast infection may spread throughout the body. In systemic candidal disease, up to 75% of people may die. Even common mouth and vaginal yeast infections can cause critical illness and can be more resistant to normal treatment.

Yeast infections that return may be a sign of more serious diseases such as diabetes, leukemia, or AIDS.

Causes

In women, yeast infections are the second most common reason for vaginal burning, itching, and discharge. Yeasts are found in the vagina of most women and can overgrow if the environment in the vagina changes. Antibiotic and steroid use is the most common reason for yeast overgrowth. But pregnancy, menstruation, sperm, diabetes, and birth control pills also can contribute to getting a yeast infection. Yeast infections are more common after menopause.


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.

Almost 15% of people with weakened immune systems develop a systemic illness caused by Candida. These infections enter into the bloodstream through breakdowns or cuts in the skin or mucous membranes. Candidal organisms may build up in an area because of frequent use of strong antibiotics, which kill the bacteria that normally keep it under control.

Use of devices implanted in the skin such as urinary catheters and IV ports also provide access for the yeast to enter the body. IV drug addicts using dirty needles may inject the yeast directly into their bloodstream or deep tissues.

Symptoms

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

In women, signs and symptoms of a vaginal yeast infection are a white cheesy discharge that typically itches and irritates the vagina and surrounding outer tissues. On occasion there may be pain with sexual intercourse or burning with urination.

In infants and adults, a candidal infection can appear many different ways.

Oral candidiasis is called thrush. Thick, white lacy patches on top of a red base can form on the tongue, palate, or elsewhere inside the mouth. These patches sometimes look like milk curds but cannot be wiped away as easily as milk can. If the white plaques are wiped away with a blade or cotton-tipped applicator, the underlying tissue may bleed. This infection also may make the tongue look red without the white coating. Thrush can be painful and make it difficult to eat. Care should be given to make sure a person with thrush does not become dehydrated.

Candidal organisms naturally live on the skin, but breakdown of the outer layers of skin promote the yeast's overgrowth. This typically occurs when the environment is warm and moist such as in diaper areas and skin folds. Superficial candidal skin infections 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. Approximately 85% of people with AIDS contract a yeast infection called esophagitis in their upper gastrointestinal (GI) systems. This infection is similar to thrush but extends down the mouth and esophagus to the stomach. Candida esophagitis can cause painful ulcers throughout the GI system, making it too painful to swallow even liquids. If the infection spreads into the intestines, food may be poorly absorbed. People with this condition are in danger of becoming dehydrated.

If Candida gets into your bloodstream, you may become sick with or without fever. If the infection spreads to your brain, you may have acute changes in mental function or behavior.


Western Medicine Treatment

Most candidal infections can be treated at home with over-the-counter or prescription medication and can clear within a week. But if some other disease has weakened your immune system, consult your doctor for any new symptoms before attempting self-treatment. You may risk getting an infection.

Most women can treat yeast infections at home with over-the-counter medications:

1) Miconazole (Monistat-Derm, Monistat Vaginal)
2) Tioconazole (Vagistat Vaginal)
3) Butoconazole (Femstat)
4) Clotrimazole (Femizole-7, Gyne-Lotrimin)


Massage these remedies into your vagina and surrounding tissues for 1-7 days depending on the formulation. If increased irritation occurs to the area, discontinue the medication immediately.

If you are pregnant, consult your doctor before using these treatments.

If symptoms continue for more than 1 week, consult your doctor.

Thrush

In thrush, swish the antifungal agent nystatin around in your mouth. Take care to maintain excellent oral hygiene.

All objects put into a child's mouth should be sterilized after each use.

Breastfeeding mothers should be evaluated for Candida of the breast.

If you wear dentures, clean them thoroughly after each use and practice good oral hygiene.

Adults have several treatment options not available to babies, such as troches (antifungal lozenges) or pills such as fluconazole (Diflucan), to help clear the infection in addition to nystatin.

Skin and diaper rash:

Clotrimazole creams and lotions can be applied to superficial skin infections. Other medications need a prescription and a visit to your doctor.

The affected area should be kept clean and dry.

For diaper rashes, frequent diaper changes and the use of barrier creams will speed recovery.

If your immune system is weak, your doctor may handle minimal local infections with home care. More serious infections may need IV medications given at the hospital.

Medical Treatment

A wide array of treatment options is available to treat candidiasis. Options include creams, lotions, pills, troches (lozenges), and vaginal suppositories. Talk to your doctor to find the option that is right for you.

Azole medications are a family of antifungal drugs that end in the suffix "-azole." They block the manufacture of ergosterol, a crucial material of the yeast cell wall. Without ergosterol, the yeast cell wall becomes leaky and the yeast die. Fortunately, ergosterol is not a component of human membranes, and azoles do not harm human cells.

Polyene antifungals include nystatin and amphotericin B. Nystatin is used for thrush and superficial candidal infections. Doctors reserve amphotericin B for more serious systemic fungal infections. The antifungals work by attaching to the yeast cell wall building material, ergosterol. These medications then form artificial holes in the yeast-wall that causes the yeast to leak and die.

Adopted from webmd.com