Oral And Vaginal Candidiasis

Overview

Candidiasis is a yeast infection by a type of fungus known as Candida albicans. Candida albicans is actually a normal flora on the skin and mucous membranes but turns into an infection when there�s an imbalance in normal commensal, mainly in the increased colonization of C. albicans. Overgrowth of yeast flora is usually due to impaired host immunity, chronic diseases or medications. Candidiasis can cause an extensive spectrum of syndromes ranging from chronic mucocutaneous candidiasis, gastrointestinal candidiasis, oropharyngeal candidiasis, respiratory tract candidiasis to genitourinary tract candidiasis. No age group is excluded from being infected with this disease including pediatrics. If left untreated, it can cause systemic invasion or fungemia, of which clinical presentation depends on a patient�s immune status.

Signs and Symptoms

Oral candidiasis: Sore and painful mouth, Burning mouth or tongue, Dysphagia, Thick, whitish patches on the oral mucosa On examination: Diffuse redness and white patches can be seen on the surfaces of the buccal mucosa, throat, tongue, and gums. Vaginal candidiasis: Itching and irritation in the vagina and vulva, A burning sensation, especially during intercourse(dyspareunia) or while urinating (dysuria), Vaginal pain and soreness On examination: Redness and swelling of the vulva, Vaginal rash, Thick, white, odor-free vaginal discharge with a cottage cheese appearance, Cervix might or might not be affected

Risk Factors

Oral candidiasis : - Impaired immunity : Susceptible group of patients are Infants and older adults, cancer patients undergoing chemotherapy and radiotherapy, organ transplantation or HIV/AIDS. - Diabetic patients due to reduced immunity and high sugar content in body provides conducive environment for candidiasis - Sexual intercourse especially at the time of first regular sexual activity. - - Medications: Long term corticosteroids or antibiotics cause a disturbance in the balance between �good� and �bad� human flora. - Wearing dentures - Dry mouth can increase the risk of oral thrush such as Sj�gren's syndrome. - Infant born to mother with vaginal candidiasis at labor. Vaginal candidiasis - Antibiotic use: Broad-spectrum antibiotics, which kill a range of bacteria, also kill healthy bacteria in your vagina, leading to overgrowth of yeast. - -- Increased estrogen levels: Yeast infections are more common pregnant women or women taking high-dose estrogen birth control pills or estrogen hormone therapy. - Uncontrolled diabetes. - Impaired immune system. Women on corticosteroid therapy or with HIV infection are more likely to get yeast infections.

Treatment and Prevention

Antifungal medication is the first line treatment but duration of treatment will depend on severity and frequency of the infection. - Azole group antifungal agents are available in the form of oral suspension (eg, nystatin, clotrimazole, amphotericin B oral suspension) or tablet form for systemic oral azoles (fluconazole, itraconazole, or posaconazole). F- or vaginal candidiasis, there are other options for antifungal medications which are available as creams, ointments, tablets and suppositories (e.g. miconazole or terconazole) Oral candidiasis - Practice good oral hygiene by making it a habit to brush and floss regularly. -- Don't share toothbrushes or other personal items. - Disinfect dentures with soap and water or special disinfecting solution for washing them. - Rinse your mouth with warm salt water rinses. - For breast-feeding mothers, use nursing pads to help prevent the fungus from spreading to your clothes. Put on a clean bra on a daily. Clean your breast nipples and disinfect bottle nipples, pacifiers and any detachable parts of a breast pump if using one. - Try limiting the amount of sugar-containing foods you eat. These may encourage the growth of candida. - Maintain good blood sugar control if you have diabetes. Vaginal candidiasis - To reduce your risk of vaginal yeast infections by wearing cotton underwear and is not too tight-fitting. - It�s best to avoid tight-fitting pantyhose and scented feminine products, including bubble bath, pads and tampons. - Never practice vaginal douching as this practice will cause disturbed the balance of normal vaginal commensals.If need to, only wash your vagina with running water and always wash front-to-back pattern. - Do not demand for unnecessary antibiotic prescriptions unless ordered by your treating doctor. - It is not advisable to stay in wet clothes, such as swimsuits and workout attire, for long periods of time.