Candidiasis. How to manage it.

Candidiasis. How to manage it.

Candidiasis is an infection caused by a fungus called candida. Several species of candida exist but, Candida albicans is the most prevalent. It can occur in the mouth, skin folds, oesophagus, genital region, and nails. When it happens in the mouth, we commonly term it as oral thrush. In the vagina, it is vaginal candidiasis. In infants, it often presents as a diaper rash.

Candidiasis. How to manage it.
Computer illustration of the unicellular fungus (yeast) Candida auris. C. auris was first identified in 2009. It causes serious multidrug-resistant infections in hospitalized patients and has high mortality rates. It causes bloodstream, wound and ear infections and has also been isolated from respiratory and urine specimens. Most C. auris infections are treatable with antifungals from the echinocandin group of drugs.

Candida fungi reside on our skin as normal flora – essentially harmless. However, they can overgrow and cause infection if their microenvironment changes to favour them. For example, when the skin area becomes too moist, all the time and exposure to antibiotics kill the good bacteria allowing the fungi to grow. Besides that, some conditions predispose a person to candidiasis. They include diabetes mellitus, cancers and chemotherapy, and steroid use. Pregnancy increases the risk of candidiasis.

Candidiasis may be the initial indicator that the person has HV. It is prevalent among people with malnutrition.

Other risk factors for candidiasis include tuberculosis, in-dwelling devices like intravenous lines, catheters, heart valves, old age, Addison’s disease, smoking, et cetera.

Outpatient Parenteral Therapy. Can a patient receive intravenous medications while commuting?

Candidiasis in different areas of the body presents differently.

Vaginal candidiasis causes itching, white patches associated with an odourless cottage cheese-like liquid (curdy) discharge.

Oral thrush features raised white patches inside the mouth or on the tongue. It may be associated with splitting or cracking on the side of the mouth (angular cheilosis), red and white sores on the gums.

Nails swell and separate along the cuticles, associated with pain at the nail base. Occasionally, they may turn yellow or black, brown.

Cutaneous candidiasis causes irritating itchy moist skin. It often affects the skin folds – in the groin and under the armpits.

Disseminated candidiasis is the invasive type. It affects more than one organ in people who are severely immunocompromised. It is fatal if not promptly managed.

We usually diagnose candidiasis based on history and examination. Wherever possible, we use a swab to take samples from the genital areas and mouth or scrapings from the nails and skin and send them to the laboratory for analysis.

We treat candidiasis with antifungal medications. They may be pills, creams, suppositories, powder, sprays, or ointment. We may treat your partner in case of genital candidiasis to prevent infection spread.

Treatment duration can range from one day to fourteen days or longer, depending on the disease type. Nail candidiasis requires treatment for a prolonged period.

A few tweaks in your lifestyle will keep you away from candidiasis.

  1. Keep your genital region clean and dry. Make it a habit to wear cotton, loose-fitting underpants. Lose weight. Do not douche and practice safe sex.
  2. Dry your hands and feet after washing them.
  3. Change the infant’s diaper timely and keep him dry to prevent a diaper rash.
  4. Maintain dry clean skin.
  5. If you have diabetes, have it under control.
  6. Do not self-medicate with antibiotics.
  7. If you are getting treatment for candidiasis without resolution, immediately call your doctor. You might be having a candida strain resistant to the drug you are currently using.
  8. While managing the disease, do not wear tight panties or have intercourse until the infection has cleared.
  9. Rubber pants increase the risk of diaper rash in infants: do not use them.

 

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