candidiasis note for bph students

1. Candidiasis
Presented By : Nawaraj Adhikari
BPH 3rd Batch (3rd Year)
Roll No: 10
Chitwan Medical College(CMC)
Candidiasis

2. a) Candida albicans is an opportunistic fungus (yeast).
b) It can infect the mouth, vagina, skin, stomach, and urinary
tract.
c) About 75% of women will get a vaginal yeast infection during
their lifetime.
d) A yeast infection results from an overgrowth of yeast anywhere
in the body.
e) Candidiasis is by far the most common type of yeast infection.
f) There are more than 20 species of Candida, the most common
being Candida albicans.
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Candidiasis

3. Candidiasis
f) These fungi live on all surfaces of our bodies. Under
certain conditions, they can become so numerous they
cause infections, particularly in warm and moist areas.
g) Candidiasis encompasses infections that range from
superficial, such as oral thrush and vaginitis, to systemic
and potentially life-threatening diseases.
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Candidiasis

5. Infectious agent
•Candida albicans (most common cause)
•Candida tropicalis (rare cause)
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6. Epidemiology
• Oral candidiasis is the most common fungal infection of the mouth,and
it also represents the most common opportunistic oral infection in
humans.
• In the Western Hemisphere, about 75% of females are affected at some
time in their lives with a vaginal yeast infection.
• Esophageal candidiasis is the most common esophageal infection in
persons with AIDS, and accounts for about 50% of all esophageal
infections, often coexisting with other esophageal diseases. About two-
thirds of people with AIDS and esophageal candidiasis also have oral
candidiasis.
• Candida is the fourth most common cause of bloodstream infections
among hospital patients in the United States.
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7. Epidemiology
•Occurrence – Worldwide. Candida albicans is often part of
the normal human flora.
•Reservoirs – Humans
•Mode of transmission –
1. contact with secretions or excretions of mouth, skin,
vagina and feces, from patients or carriers.
2. Passage from mother to neonate during childbirth.
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8. 1. Incubation period – variable.
2. Period of communicability - presumably while lesions
are present.
3. Susceptibility and resistance –
i. Susceptibility is very low except in low host defense. It is
common in diabetes, HIV infected; women are prone to
vulvovaginitis in the third trimester of pregnancy.
ii. Oral contraceptive users, individuals with prolonged
steroid therapy are susceptible.
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9. Signs and symptoms
1. Signs and symptoms of candidiasis vary depending on the
area affected.
2. Most candidal infections result in minimal complications
such as redness, itching, and discomfort, though
complications may be severe or even fatal if left untreated.
3. In immunocompetent persons, candidiasis is usually a very
localized infection of the skin or mucosal membranes,
including the oral cavity(thrush), the pharynx or esophagus,
the gastrointestinal tract, the rectum, anus,
perianal/perirectal or ano-rectal area (in men as well as
women), the perineum, the urinary bladder, the fingernails
or toenails (onychomycosis), and the genitalia
(vagina, penis, etc.).
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10. Signs and symptoms
3. Infection of the vagina or vulva may cause severe itching,
burning, soreness, irritation, and a whitish or whitish-
gray cottage cheese-like discharge.
4. In immunocompromised patients, Candida infections can
affect the esophagus causing more serious condition, called
candidemia.
5. Thrush is commonly seen in infants.
6. Children, mostly between the ages of three and nine
years of age, can be affected by chronic mouth yeast
infections, normally seen around the mouth as white
patches. However, this is not a common condition.
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11. 7) 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.
8) Esophageal candidiasis can cause difficulty swallowing, or less
commonly painful swallowing. Abnormal proliferation of the candida
in the gut may lead to dysbiosis.
9) While it is not yet clear, this alteration may be the source of
symptoms generally described as the irritable bowel syndrome, and
other gastrointestinal diseases.
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Signs and symptoms

12. Clinical manifestation
•Severe vulvar pruritis (prominent feature An intense itching
sensation that can have various causes)
•vaginal discharge (scanty, whitish, yellow, thick to form
curds, non-offensive)
•sore vulva due to itching
•speculum examination – thick whitish plugs attached to
vaginal wall
•vaginal epithelium bleeds when the plug is removed but the
cervix is normal
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13. Causes
•A weakened or undeveloped immune system or metabolic
illnesses such as diabetes are significant predisposing factors
of candidiasis.
•Candida yeasts are commonly present in humans, and their
growth is normally limited by the human immune system and
by other microorganisms, such as bacteria occupying the
same locations in the human body.
•Diseases that increase the risk of candidiasis
include HIV/AIDS, mononucleosis, cancer treatments, steroi
ds, stress, antibiotics, diabetes, and nutrient deficiency.
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14. •Pregnancy and the use of oral contraceptives have been
reported as risk factors.
•Diabetes mellitus and the use of antibiotics are also linked to
increased rates of yeast infections.
•Diets high in simple carbohydrates have been found to affect
rates of oral candidiasis.
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15. Conditions
•Candida infection more likely to develop in some cases,
including:
-Diabetes,
-HIV infection,
-Cancer,
-Dry mouth, and
-Pregnancy.
•Cases of oral and esophageal candidiasis in HIV/AIDS
patients were estimated at 10,347 and 2950, respectively
in Nepal according to medical research in 2015.
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16. Prognosis
•Among individuals being treated in intensive care units,
the mortality rate is about 30-50% when systemic candidiasis
develops.
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17. Diagnosis
•Based on clinical grounds
•Microscopic demonstration of pseudohyphae or yeast cells in
infected tissue or body fluids (vaginal discharge)
•Culture (vaginal discharge)
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18. Treatment
Candidiasis is commonly treated with antimycotics;
these antifungal drugs include :
1. Topical Nystatin Vaginal Pessary or
2. Miconazole Or Topical Clotrimazole Creams or
3. Topical Ketoconazole or
4. Fluconazole in recurrent cases
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19. Prevention and control
•Case treatment
•Treatment of underlying medical conditions or predisposing
factors
•Maintaining personal cleanliness and hygiene by regular
cleaning of genital organs
•Health education regarding the preventive and curative aspect
of candidiasis infections to women and adolescent girls
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20. Prevention and control
•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.
•Wearing cotton underwear may help to reduce the risk of
developing skin and vaginal yeast infections, along with not
wearing wet clothes for long periods of time.
•Oral hygiene can help prevent oral candidiasis when people
have a weakened immune system.
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Oral Candidiasis (Thrush)

22. Thrush
•Thrush is a yeast infection of
the mucus membrane lining the
mouth and tongue.
•Oral infections are most
common in infants, elderly
people, and those with a
weakened
immune system.
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23. Causes
•Thrush is caused by forms of a fungus called Candida. A
small amount of this fungus lives in our mouth most of the
time. It is usually kept in check by your immune system and
other types of germs that also normally live in your mouth.
•However, when our immune system is weak, the fungus can
grow.
•Thrush is commonly seen in infants. It is not considered
abnormal in infants unless it lasts longer than a couple of
weeks.
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24. Symptoms
• Thrush usually develops suddenly, but it may become
chronic, persisting over a long period of time.
• A common sign of thrush is the presence of creamy white,
slightly raised lesions in your mouth -usually on tongue.
•The lesions, can be painful and may bleed slightly when
scrape them or brush teeth.
•In severe cases, the lesions may spread into your esophagus,
or swallowing tube, causing pain or difficulty swallowing.
•Thrush can spread to other parts of the body, including the
lungs, liver, and skin.
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Thrush

26. Treatment
•Medications that inhibit the growth of fungi (antifungals) are
the standard treatment for thrush.
•These medications are either applied directly to the affected
area (topical) or swallowed (oral).
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27. Cutaneous candidiasis
•Cutaneous candidiasis include:
•Paronychia and onychomycosis.
•Diaper candidiasis.
•Intertrigo candidiasis.
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28. Cutaneous candidiasis
Paronychia:-
•Paronychia of the finger nails may develop in persons
whose hands are subject to continuous wetting, especially
with sugar solutions or contact with flour, that softens the
nail folds and cuticle.
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• In chronic cases the
infection may progress to
cause onychomycosis with
total detachment of the
cuticle from the nail plate.

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Paronychia

30. Cutaneous candidiasis
Diaper candidiasis :-
•Diaper candidiasis is common in infants under unhygienic
conditions of chronic moisture and local skin maceration
associated with ammonitic irritation due to irregularly
changed unclean diapers.
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31. References
• http://www.emedicinehealth.com/slideshow_skin_problems/article_em.htm
• http://www.umm.edu/altmed/articles/candidiasis-000030.htm
• http://www.mycology.adelaide.edu.au/Mycoses/Cutaneous/Candidiasis/
• http://www.emedicinehealth.com/candidiasis_yeast_infection/article_em.htm
• http://en.wikipedia.org/wiki/Candidiasis
• http://en.wikipedia.org/wiki/Oral_candidiasis
• http://www.skinsight.com/adult/oralCandidiasisThrush.htm
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