What is Candidiasis?

Infections of the fungus Candida are opportunistic. That means your immune system must be weakened for it to appear.

What is candidiasis?

Candidiasis is a mycosis, an infection produced by fungus belonging to the Candida species.

  • They may be acute, subacute, or chronic infections.
  • They affect the skin, mucous membranes, and deep tissues.
  • Symptoms are very variable.
  • The prognosis is also very variable, ranging from mild mucocutaneous infections to life-threatening in the case of severe immunosuppression.
  • They are opportunistic mycosis.

Candida spp

This is a type formed by yeast-like fungus, mostly unicellular. Within this type three kinds we’re interested in here are:

  • Candida albicans: This is the most aggressive kind and responsible for more than half of symptoms.
  • Candida glabrata
  • C. parapsilosis: Associated with the use of catheters and needles.
  • C. krusei: Associated with taking Flukonazol (an antifungal)
* The spp is used to refer to all species that are part of the kind.

What are opportunistic pathogens?

Opportunistic pathogens are those that don’t infect a healthy person in normal conditions. There must be an alteration in one of the biological barriers of the immune system for it to happen.

The Candida type, just like most fungus and some bacteria, belongs to this group of pathogens. In fact, Candida is part of the normal flora of the skin and mucous membranes of a large percentage of people.

How is candidiasis produced?

From an alteration in mechanical barriers: damage in the skin or mucous membranes (primary barriers)

This is what happens in people with catheters, prosthesis, or on dialysis. It likewise explains infection in intravenous drug users.

“If the fungus moves to the bloodstream, it can affect almost any organ of the body. This happens in patients with severely suppressed immune systems (uncontrolled HIV and terminal stage leukemia).”

Damage in the skin or mucous membranes keeps them from fulfilling their role as a barrier, allowing the growth of fungus. So that’s how syringes piercing the skin or catheters wearing away the mucous membrane make a person predisposed to this infection.

Due to alterations in bacteria flora

Damage in the bacteria flora is often produced by taking broad-spectrum antibiotics. This can be explained by how widely these antibiotics act. They “attack” both the bacteria responsible for the infection as well as the normal flora. So when this barrier is gone, the possibility of mycosis arises.

For example, it’s relatively common to find cases of vaginal candidiasis in young women after taking antibiotics.

States of immunosuppression

Whether it’s from an illness, like in patients with HIV, or from medication, like in transplant patients taking anti-rejection medication.


Superficial candidiasis

Muguet (oropharyngeal candidiasis)

This type is characterized by the appearance of white pseudomembranes covering the tongue, soft palate, and oral mucous membranes. When removed, you uncover a reddened, worn-down surface. They can be very painful. This can make swallowing and breathing difficult.

They most often appear in people with HIV (up to 90% of cases), being one of the first signs of this disease. Although it’s one of the most common opportunistic infections that affect this group of patients, incidence has gone down in recent years.

It also affects people with cancer due to their weakened immune system, and newborns because they are still developing.

Vaginitis and vulvovaginitis Candida

This kind is also relatively common. Clinically characterized by:

  • Very strong burning feeling in the vulva and vagina, especially when urinating.
  • Severe reddening in the genital mucous membranes.
  • Appearance of white spots on the reddened mucous membranes.
  • Whiteish, thick vaginal secretion, with lumps. Described as looking like “cottage cheese.”

 

Balanitis Candida

This type is less common than vaginitis. Normally it appears along with diabetes, in uncircumcised individuals or with a history of candidiasis in a sexual partner.

Red, raw-looking lesions and superficial pustules appear on the glans and foreskin, and they are usually painful. They may come along with a burning sensation that gets worse during urination.

Skin candidiasis

This kind generally forms in skin folds and areas where tight clothing is worn. In both cases, your body creates a warm, moist environment.

This environment creates a red rash with bad itching. It normally happens under the breasts, on one’s bottom, in the genital area, as well as other areas. In addition, sometimes it infects skin follicles and looks like pimples.

It’s relatively common for nursing infants with diaper rash to be infected with Candida, making symptoms worse.

APECED: type 1 autoimmune polyendocrinopathy

A rare genetic disease from a mutation in the AIRE gene.

The illness starts in childhood with repeated candidiasis of the nails and mouth with no apparent cause.

Then later on, autoimmune dysfunctions appear in different glands. Also, we add symptoms of hypoparathyroidism, adrenal failure, and Addison’s disease.

Deep candidiasis

Esophageal Candida

Commonly found in immunosuppressed people. Very common in people with HIV or lymphoma. And also seen less frequently in people treated with corticoids. Some serious symptoms:

  • A burning feeling underneath the sternum.
  • Difficulty swallowing (dysfagia)
  • Pirosis (heartburn)

Also, whiteish pseudomembranes appear along the esophageal mucous membranes.

Invasive candidiasis

Here the fungus moves to the bloodstream with the potential to affect any organ of the body. This also appears in patients with very severely suppressed immune systems (uncontrolled HIV or terminal stage leukemia).

It is a very serious symptom, most of the time with a poor prognosis.

Diagnosis

Diagnosis comes from obtaining and analyzing cultures. 

A doctor obtains it with a swab of the affected area and then cultured. Then a doctor can analyze them under a microscope.

Prevention and treatment

Further, good personal hygiene is important for prevention. After showering, you should then dry the folds of your skin well and take proper care of the genital region. For pregnant women, it’s also a good idea to include bioactive yogurt into your diet to maintain proper vaginal acidity.

Treatment depends on the type of mycosis. A typical treatment is clotrimazole.