Candida is the scientific name for a genus of fungi. Candida infections, also called candidiasis, are often referred to as yeast or fungal infections. When they occur in the mouth and throat, Candida infections are called thrush. The most common sites of infection include the mouth and throat, the genitals, and moist skin folds. Candida can also cause a systemic, or body-wide, infection, but this is very rare, occurring in less than 0.1% of cases every year in the United States (Source: CDC).
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Candida can cause inflammation in the infected tissues. Cutaneous, or skin, Candida infections tend to appear as red, weepy, scaly areas. Candida infections can also cause pus-filled bumps. In the mouth and throat, the infection often forms thick, white patches. Genital Candida infections often produce a thick, white vaginal discharge.
Candida occurs naturally in the environment and may also be present on skin surfaces, in the mouth and digestive tract, and in the vagina without causing problems. However, infections can occur in otherwise healthy people when they take antibiotics or have areas of skin that are constantly moist. People with weakened immune systems are at higher risk of developing Candida infections, including systemic infections.
Treated appropriately, Candida infections often resolve, although they may recur.
Candida infections are rarely serious or life threatening unless they are systemic infections. Seek immediate medical care (call 911) for serious symptoms, such as fever and chills that don’t improve, confusion, lethargy, loss or change in level of consciousness, seizure, decreased urine output, rapid heart rate, chest pain, severe abdominal pain, and unusual irritability or poor feeding in a child.
Seek prompt medical care if you have never had a Candida infection before and believe you have one, if you are being treated for Candida but symptoms recur or are persistent, or if you have any other concerns. Also seek prompt medical care if you have fevers and chills that are not responsive to therapy or have difficulty swallowing.
What are the symptoms of Candida?
Symptoms of Candida depend on the site of infection. Cutaneous Candida infections, on the skin surface, tend to appear as red, weepy, scaly areas. Candida infections can also cause pus-filled bumps. In the mouth and throat, the infection often forms thick, white patches. Genital Candida infections often produce a thick, white vaginal discharge. Some diaper rashes are caused by Candida.
Systemic Candida infections produce nonspecific symptoms such as fever and chills. Other symptoms can occur and tend to be related to the organs involved.
Common symptoms of cutaneous Candida
Cutaneous (skin) Candida infections have some characteristic features including:
- Feeling of warmth in the affected area
- Itchy skin
- Lesions in moist areas such as under skin folds
- Lesions that cluster and run together
- Pus-filled bumps
- Red, inflamed, weepy skin
- Scalloped borders around the skin lesions
- Scaly areas over the reddened skin
Common symptoms of thrush
Candida can cause infection and inflammation in the mouth, nasal passages, and throat, which is known as thrush, or oropharyngeal candidiasis. Symptoms of thrush include:
- Burning feeling or painful sensation in the mouth or on the tongue
- Difficulty swallowing
- Redness
- Splitting or cracking of the corners of the mouth (angular cheilitis)
- Thickened white patches visible inside the mouth and on the tongue
Common symptoms of genital Candida
Although it is more common in women, genital candidiasis also occurs in men. Symptoms of genital Candida infection include:
- Burning feeling or feeling of warmth in the affected area
- Itching feeling
- Pain during sexual intercourse
- Pain with urination
- Red, inflamed, weepy skin
- Scalloped borders around the skin lesions
- Scaly areas over the reddened skin
- Swelling
- Thick, white vaginal discharge with a texture similar to cottage cheese
Common symptoms of systemic Candida
Systemic Candida infections do not always causes symptoms. When they do, the symptoms may be nonspecific unless a particular organ is involved. Symptoms of systemic Candida infections include:
- Fever and chills
- Headache
- Muscle or joint pain
- Neck stiffness
- Rash
Serious symptoms that might indicate a life-threatening condition
In some cases, Candida can cause life-threatening infections. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:
- Change in level of consciousness or alertness, such as passing out or unresponsiveness
- Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions
- Chest pain, chest tightness, chest pressure, palpitations
- Decreased urine output
- High fever (higher than 101 degrees Fahrenheit)
- Severe abdominal pain
- Severe dizziness or sudden loss of balance
- Severe headache
- Unusual irritability or poor feeding in a child
- Unusual neck stiffness or pain
What causes Candida?
Although various species of Candida can cause infection, most infections are caused by Candida albicans. Candida infections are generally not considered contagious. Candida is present in the environment and can be carried by healthy people without causing symptoms.
People with weakened immune systems have the highest risk of developing candidal infections. These tend to develop in the brain, the esophagus, as well as disseminated infection throughout the body. Antibiotic and corticosteroid treatments can increase the risk of genital infections in women, as can pregnancy and diabetes.
Hospitalized individuals admitted to the Intensive Care Unit (ICU) are at greatest risk for developing candidiasis due to the presence of indwelling intravenous lines, feeding tubes, urinary catheters and respiratory ventilatory tubes – all of which provide a direct pathway for infection.
A number of factors increase the risk of developing cutaneous Candida infections. Not all people with risk factors will get Candida infections. Risk factors for cutaneous Candida infection include:
DiabetesDiaper use
Obesity
Weakened immune system, such as occurs in people who have AIDS (acquired immunodeficiency syndrome), are undergoing cancer treatment, or have had an organ transplant
A number of factors increase the risk of developing oral candidiasis, or thrush, including:
Denture use
Infancy
Treatment with corticosteroids
Weakened immune status
A number of factors increase the risk of developing genital Candida infections including:
Diabetes
Oral contraceptives
Pregnancy
Treatment with corticosteroids
Weakened immune status
Systemic Candida infections are uncommon, but certain people have a higher risk than others. Risk factors for systemic Candida infections include:
Prolonged catheter use
Prolonged hospitalization
Prolonged mechanical ventilation
Prolonged treatment with antibiotics or corticosteroids
Severe trauma or burns
Surgery
Very low birth weight and preterm babies
Weakened immune status
Reducing your risk of Candida
You can reduce your risk of developing a Candida infection by:
Avoiding the use of douches and feminine hygiene sprays, perfumes, and powdersChanging baby diapers frequently
Eating yogurt with live cultures while taking antibiotics
Keeping your blood sugar levels under control
Keeping your skin clean and dry
Losing weight if you are overweight
Practicing good hygiene
Using a soft toothbrush
Using body powders to absorb moisture
Washing with warm water only and avoiding scented soaps or wipes
Wearing loose, airy clothing
How is Candida treated?
Treatment for Candida typically involves the use of antifungal medications, although oral thrush in babies often goes away on its own. The type of antifungal therapy depends on the site and severity of the infection, and whether any past treatment was effective. Antifungal medications may be topical, oral or intravenous.
Topical antifungal medications used to treat Candida
Topical antifungal medications can be used for cutaneous candidiasis, thrush, or genital candidiasis. Topical antifungal agents used for these conditions include:
Butoconazole (Femstat) vaginal creamClotrimazole (Lotrimin, Mycelex) topical cream, vaginal cream, or vaginal suppositories
Clotrimazole lozenges
Ketoconazole (Nizoral) topical cream
Miconazole (Micatin, Monistat) topical cream or vaginal cream
Nystatin “swish and swallow” oral suspension
Tioconazole (Vagistat) vaginal cream
Oral antifungal medications used to treat Candida
Oral antifungal drugs may be used for cutaneous candidiasis, thrush, or genital candidiasis, especially for infections that are more severe or that fail to resolve with topical treatment, or for systemic Candida infections. Oral antifungal medications used to treat Candida infections include:
Fluconazole (Diflucan)Ketoconazole (Nizoral)
Voriconazole (Vfend)
Intravenous antifungal medications used to treat Candida
Systemic candidiasis is often treated with intravenous antifungal medications including:
Amphotericin BAnidulafungin (Eraxis)
Caspofungin (Cancidas)
Fluconazole (Diflucan)
Micafungin (Mycamine)
Voriconazole (Vfend)
It is important for you to complete the entire course of treatment to prevent recurrence and reduce the risk of complications of Candida infections. Also, it is possible for Candida to become resistant to antifungal medications. Completing the entire course of medication as recommended and using antifungal medications only when a candidal or other fungal infection is present helps prevent antifungal resistance.
What you can do to improve your Candida
In addition to managing your risk factors, you can also soothe some of the symptoms of your Candida infection by:
Applying warm compresses on genital infections and gently patting the area dry afterwardAvoiding scratching or picking at the infected areas
Taking over-the-counter pain relief medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)
Using over-the-counter hydrocortisone creams temporarily as needed for itching
Complications of Candida infections, particularly those that are systemic, can be serious, even life threatening in some cases. People with weakened immune systems have the highest risk of complications. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of Candida infection include:
Abscess formation in the spleenArthritis
Encephalitis (brain inflammation)
Esophagitis (inflammation or infection of the esophagus)
Endophthalmitis (inflammation or infection inside the eye)
Inflammation and infections of the heart, such as endocarditis (inflammation of the heart valves and lining), myocarditis (infection of the middle layer of the heart wall), and pericarditis (infection of the lining that surrounds the heart)
Malnutrition
Meningitis (infection or inflammation of the sac around the brain and spinal cord)
Peritonitis (infection of the lining that surrounds the abdomen)
Recurrent or persistent infection
Secondary infection of skin lesions
