Candidiasis

[2][10] Signs and symptoms include genital itching, burning, and sometimes a white "cottage cheese-like" discharge from the vagina.

[5] Conditions that result in a weak immune system include HIV/AIDS, the medications used after organ transplantation, diabetes, and the use of corticosteroids.

[5][14] Vaginal infections occur more commonly during pregnancy, in those with weak immune systems, and following antibiotic therapy.

In healthy (immunocompetent) persons, candidiasis is usually a localized infection of the skin, fingernails or toenails (onychomycosis), or mucosal membranes, including the oral cavity and pharynx (thrush), esophagus, and the sex organs (vagina, penis, etc.

[33] Infection of the vagina or vulva may cause severe itching, burning, soreness, irritation, and a whitish or whitish-gray cottage cheese-like discharge.

Symptoms of infection of the male genitalia (balanitis thrush) include red skin around the head of the penis, swelling, irritation, itchiness and soreness of the head of the penis, thick, lumpy discharge under the foreskin, unpleasant odour, difficulty retracting the foreskin (phimosis), and pain when passing urine or during sex.

[35] Common symptoms of gastrointestinal candidiasis in healthy individuals are anal itching, belching, bloating, indigestion, nausea, diarrhea, gas, intestinal cramps, vomiting, and gastric ulcers.

[26][27][28] Perianal candidiasis can cause anal itching; the lesion can be red, papular, or ulcerative in appearance, and it is not considered to be a sexually transmitted infection.

[37] While it is not yet clear, this alteration may be the source of symptoms generally described as the irritable bowel syndrome,[38][39] and other gastrointestinal diseases.

[42] For example, wearing wet swimwear for long periods of time is believed to be a risk factor.

[44] Factors that increase the risk of candidiasis include HIV/AIDS, mononucleosis, cancer treatments, steroids, stress, antibiotic therapy, diabetes, and nutrient deficiency.

[46] Treatment with antibiotics can lead to eliminating the yeast's natural competitors for resources in the oral and intestinal flora, thereby increasing the severity of the condition.

[citation needed] External use of detergents or douches or internal disturbances (hormonal or physiological) can perturb the normal vaginal flora, consisting of lactic acid bacteria, such as lactobacilli, and result in an overgrowth of Candida cells, causing symptoms of infection, such as local inflammation.

[52] In penile candidiasis, the causes include sexual intercourse with an infected individual, low immunity, antibiotics, and diabetes.

[54] In oral candidiasis, simply inspecting the person's mouth for white patches and irritation may make the diagnosis.

The characteristics (such as morphology and colour) of the colonies may allow initial diagnosis of the organism causing disease symptoms.

[28] Candidiasis may be divided into these types: A diet that supports the immune system and is not high in simple carbohydrates contributes to a healthy balance of the oral and intestinal flora.

[55] Candidiasis is treated with antifungal medications; these include clotrimazole, nystatin, fluconazole, voriconazole, amphotericin B, and echinocandins.

[20] The 2016 revision of the clinical practice guideline for the management of candidiasis lists a large number of specific treatment regimens for Candida infections that involve different Candida species, forms of antifungal drug resistance, immune statuses, and infection localization and severity.

[71] For vaginal yeast infection in pregnancy, topical imidazole or triazole antifungals are considered the therapy of choice owing to available safety data.

[72] In vaginal yeast infection in pregnancy, treatment with topical azole antifungals is recommended for seven days instead of a shorter duration.

[75] Among individuals being treated in intensive care units, the mortality rate is about 30–50% when systemic candidiasis develops.

[81] Candida is the fourth most common cause of bloodstream infections among hospital patients in the United States.

[22] The first description of a fungus as the causative agent of an oropharyngeal and oesophageal candidosis was by Bernhard von Langenbeck in 1839.

[86] The colloquial term "thrush" is of unknown origin but may stem from an unrecorded Old English word *þrusc or from a Scandinavian root.

[85] The genus Candida and species C. albicans were described by botanist Christine Marie Berkhout in her doctoral thesis at the University of Utrecht in 1923.

The current classification is nomen conservandum, which means the name is authorized for use by the International Botanical Congress (IBC).

A 2005 publication noted that "a large pseudoscientific cult"[89] has developed around the topic of Candida, with claims stating that up to one in three people are affected by yeast-related illness, particularly a condition called "Candidiasis hypersensitivity".

[90] Some practitioners of alternative medicine have promoted these purported conditions and sold dietary supplements as supposed cures; a number of them have been prosecuted.

[90][91] In 1990, alternative health vendor Nature's Way signed an FTC consent agreement not to misrepresent in advertising any self-diagnostic test concerning yeast conditions or to make any unsubstantiated representation concerning any food or supplement's ability to control yeast conditions, with a fine of $30,000 payable to the National Institutes of Health for research in genuine candidiasis.

Skin candidiasis
Nail candidiasis ( onychomycosis )
Vaginal swab wet mount of candida (phase contrast) showing the pseudohyphae
Agar plate culture of C. albicans
KOH test on a vaginal wet mount , showing slings of pseudohyphae of Candida albicans surrounded by round vaginal epithelial cells, conferring a diagnosis of candidal vulvovaginitis
Micrograph of esophageal candidiasis showing hyphae, biopsy specimen, PAS stain
Gram stain of Candida albicans from a vaginal swab; the small oval chlamydospores are 2–4 μm in diameter
Chromogenic agar can help in indicating the involved species of Candida versus similar fungi. (CHROMAgar shown)
Algorithm for the diagnosis of Candida versus differential diagnoses.