Candidiasis Health Article

Definition

Candidiasis is an infection caused by a species of the yeast Candida, usually Candida albicans. This is a common cause of vaginal infections in women. Also, Candida may cause mouth infections in people with reduced immune function, or in patients taking certain antibiotics. Candida can be found in virtually all normal people but causes problems in only a fraction. In recent years, however, several serious categories of candidiasis have become more common, due to overuse of antibiotics, the rise of AIDS, the increase in organ transplantations, and the use of invasive devices (catheters, artificial joints and valves)—all of which increase a patient's susceptibility to infection.

Vaginal candidiasis

Although most cases of vaginal candidiasis are cured reliably, these infections can recur. To limit recurrences, women may need to take a prescription anti-fungal drug such as terconazole (sold as Terazol) or take other anti-fungal drugs on a preventive basis.

Oral candidiasis

These infections can also recur, sometimes because the infecting Candida develops resistance to one drug. Therefore, a physician may need to prescribe a different drug.

Deep organ candidiasis

The prognosis depends on the category of disease as well as on the condition of the patient when the infection strikes. Patients who are already suffering from a serious underlying disease are more susceptible to deep organ candidiasis that speads throughout the body.

Diagnosis

Often clinical appearance gives a strong suggestion about the diagnosis. Generally, a clinician will take a sample of the vaginal discharge or swab an area of oral plaque, and then inspect this material under a microscope. Under the microscope, it is possible to see characteristic forms of yeasts at various stages in the lifecycle.

Fungal blood cultures should be taken for patients suspected of having deep organ candidiasis. Tissue biopsy may be needed for a definitive diagnosis.

Alternative treatment

Home remedies for vaginal candidiasis include vinegar douches or insertion of a paste made from Lacto-bacillus acidophilus powder into the vagina. In theory,

these remedies will make the vagina more acidic and therefore less hospitable to the growth of Candida. Fresh garlic (Allium sativum) is believed to have antifungal action, so incorporating it into the diet or inserting a gauze-wrapped, peeled garlic clove into the vagina may be helpful. The insert should be changed twice daily. Some women report success with these remedies; they should try a conventional treatment if an alternative remedy isn't effective.

Prevention

Because Candida is part of the normal group of microorganisms that co-exist with all people, it is impossible to avoid contact with it. Good vaginal hygiene and good oral hygiene might reduce problems, but they are not guarantees against candidiasis.

Because hospital-acquired (nosocomial) deep organ candidiasis is on the rise, people need to be made aware of it. Patients should be sure that catheters are properly maintained and used for the shortest possible time length. The frequency, length, and scope of courses of antibiotic treatment should also be cut back.

BOOKS

Carlson, K. J., S. A. Eisenstat, and T. Ziporyn. The Harvard Guide to Women's Health. Harvard University Press, 1996.

PERIODICALS

Greenspan, Deborah, and John S. Greenspan. "HIV-Related Oral Disease." The Lancet 348 (14 Sept. 1996): 729-734.

Tobin, Marla J. "Vulvovaginal candidiasis: Topical vs. Oral Therapy." American Family Physician 51 (15 May 1995): 1715-1723.

Richard H. Lampert

KEY TERMS

Biopsy—The removal and examination of tissue from a live body.

Colonize—To become established in a host.

Granulocytopenia—A condition characterized by a deficiency of white blood cells.

Nasogastric—Tube inserted through the nasal passages into the stomach.

Opportunistic—Infection caused by microorganisms that are usually harmless, but which can cause disease when a host's resistance is lowered.

Systemic—Afflicting an entire body system or the body in general.