Candidiasis – Causes, Diagnosis, and Prevention.

Description

Candidiasis is an infection caused by the microorganism called Candida albicans mostly occurs on the skin. Candida is a type of yeast or fungus, and candidiasis is called a yeast infection. There are more than 20 types of Candida and they can live in our bodies causing no problems at all. However, in warm, moist conditions the fungi can multiply and cause infections. These can range from the harmless but irritating, some of them are vaginal thrush or nappy rash and infections that spread through the entire body, especially with the weakened immune systems can be life-threatening. Adults can also have yeast infections under the breast and beneath other skin folds.

Affecting areas of Candida

Types of candidiasis

• Oral candidiasis or Esophagitis: Candidiasis that occurs in the mouth is a mycosis of Candida species present in the mucous membrane of the mouth.
• Vaginal candidiasis: Candidiasis in the vagina is commonly called a vaginal yeast infection or vaginal thrust.
• Nail candidiasis: When dermatophytes infect the nails, the nails become thick, swollen and tender, split, become dull, and may fall off.
• Armpit candida: when candida species affects the skin under armpit eventually skin turns red and can be little raw.

Pathogenesis of candidiasis

• albicans containing various known virulence factors which help in the spreading of infections in the human being and favors its pathogenicity.
• The virulence factors of the albicans have the great role in the pseudohyphae formation by attached with epithelial cells (in respiratory tract), endothelial cells (in blood vessels), hyphal switching, surface recognition molecules, phenotypic switching and extracellular hydrolytic enzyme i.e. proteinase and phospholipase production have been suggested to be virulence attributes for Candida.

Pathogenesis of candidiasis

• Extracellular hydrolytic enzymes seem to play an important role in candida overgrowth, as these enzymes facilitate adherence and tissue penetration and hence the invasion of the host, among the most important hydrolytic enzymes produced by Candida are phospholipases and secreted aspartyl proteinases.
• Due to their virulence factors like adhesions property, the colonization of the Candida is take place in superficial tissue (local site) or it invades the deeper into the host tissue in yeast form but they transformed into the hyphal form during active infection.

Epidemiology

• Although albicans is the most common cause of candidemia, there has been the increased isolation of non-albicans species of Candida in recent years.
• In a multi-center surveillance study conducted in the United States between 2004 and 2008, 54% of 2019 bloodstream isolates represented non-albicans Candida spp and 46% represented albicans.

Causes of candidiasis

Yeast overgrowth can be triggered by:

• Antibiotics
• Steroids
• Contraceptive pills
• Catheters and IV drips
• Pregnancy
• Menstruation
• Sperm
• Diabetes

Risk factors

• Patients who have a central venous catheter
• When consumed with broad-spectrum antibiotics
• Very low neutrophil in blood
• People who experience kidney failure or undergoing hemodialysis
• People who underwent surgery, especially gastrointestinal surgery
• Eating a diet high in sugar and refined carbs
• High alcohol intake
• A weakened immune system
• Taking oral contraceptives
• High-stress levels

Symptoms of candidiasis

• Oral Thrush
• Tiredness and Fatigue
• Recurring Genital or Urinary Tract Infections
• Digestive Issues
• Sinus Infections
• Skin and Nail Fungal Infections

• Joint Pain

Complications due to candidiasis

• Depression
• Psychosexual problems
• Male thrush- If a candidiasis woman is having sexual contact with their partner male thrush arises.

• If vaginal candidiasis is left untreated, it can cause vaginitis, which is an inflammation of the vagina
• Fungal infections- The most common fungal infection that can occur is tinea (ringworm)

Diagnosis and test

Lab Tests

Comprehensive Stool Analysis: A stool analysis starts with sample collection. At the lab, your stool will be analyzed for levels of yeast, pathogenic bacteria, and friendly bacteria. Especially the Candida albicans and several other pathogenic microorganisms are witnessed. Also examining for pH, inflammation markers, and conducting a thorough evaluation of your gut health and digestive processes.

Candida Antibodies Test: Our immune system produces three different types of antibodies in response to a Candida infestation. These are the IgG, IgA, and IgM antibodies. The levels of each of these antibodies indirectly signify the Candida overgrowth or have been present in the recent past.

Organic Acid Test: Candida overgrowth leaves evidence is your urine. There are certain organic waste products created by Candida albicans that are not naturally found in your body. By looking for these waste products in your urine, it is possible to evaluate whether there is an imbalance in the gut and to guess at which pathogenic organisms might be causing it.

The Spittle Test: Here’s a simple test that some people claim will diagnose your Candida overgrowth.

1. When you get up in the morning, and before you brush your teeth, eat or drink anything, fill a glass with bottled water at room temperature.
2. Spit some saliva gently into the glass.
3. Come back every 20 minutes for the next hour and check for some of these ‘tell-tale signs’ of Candida:

• Strings’ coming down through the water from the saliva at the top
• Cloudy saliva sitting at the bottom of the glass
• Opaque specks of saliva suspended in the water

Gastrointestinal candidiasis

Endoscopy with or without biopsy is necessary to establish the diagnosis.

Treatment and medications

Treatment of candidiasis varies, depending on the area affected:

• Thrush – Usually treated with topical, antifungal medications such as nystatin (Mycostatin and others) and clotrimazole.
• Esophagitis – it can be treated with an oral anti-fungal drug such as fluconazole.
• Cutaneous candidiasis – This skin infection can be effectively treated with a variety of antifungal powders and creams. The affected area must be kept clean and dry and protected from chafing.
• Vaginal yeast infections: Vaginal yeast infections can be treated with antifungal medications such as butoconazole (Femstat), clotrimazole (Gyne-Lotrimin), miconazole (Monistat, Vagistat, and others), nystatin (Mycostatin and others), and tioconazole (Monistat-1, Vagistat-1). A single dose of oral fluconazole can be used. Sex partners usually do not need to be treated.
• Deep candidiasis: This infection usually starts with an intravenous anti-fungal drug, such as voriconazole or fluconazole. People with very low white blood cell counts may need an alternative intravenous anti-fungal drug, such as caspofungin or micafungin.

Prevention

• Eat a balanced diet rich in fruits, vegetables, whole grains, and non-fat dairy products.
• Control diabetes: Good control of blood sugar levels decreases the risk of yeast infections anywhere on your body.
• Avoid unnecessary use of antibiotics.