Candidiasis prepared by nawaraj adhikari

candidiasis note for bph students

1. Candidiasis
PresentedBy:NawarajAdhikari
BPH3
rd
Batch(3
rd
Year)
RollNo:10
ChitwanMedicalCollege(CMC)
Candidiasis

2. a)Candidaalbicansisanopportunisticfungus(yeast).
b)Itcaninfectthemouth,vagina,skin,stomach,andurinary
tract.
c)About75%ofwomenwillgetavaginalyeastinfectionduring
theirlifetime.
d)Ayeastinfectionresultsfromanovergrowthofyeastanywhere
inthebody.
e)Candidiasisisbyfarthemostcommontypeofyeastinfection.
f)Therearemorethan20speciesofCandida,themostcommon
beingCandidaalbicans.
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Candidiasis

3. Candidiasis
f)Thesefungiliveonallsurfacesofourbodies.Under
certainconditions,theycanbecomesonumerousthey
causeinfections,particularlyinwarmandmoistareas.
g)Candidiasisencompassesinfectionsthatrangefrom
superficial,suchasoralthrushandvaginitis,tosystemic
andpotentiallylife-threateningdiseases.
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Candidiasis

5. Infectious agent
•Candidaalbicans(mostcommoncause)
•Candidatropicalis(rarecause)
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6. Epidemiology
•Oralcandidiasisisthemostcommonfungalinfectionofthemouth,and
italsorepresentsthemostcommonopportunisticoralinfectionin
humans.
•IntheWesternHemisphere,about75%offemalesareaffectedatsome
timeintheirliveswithavaginalyeastinfection.
•Esophagealcandidiasisisthemostcommonesophagealinfectionin
personswithAIDS,andaccountsforabout50%ofallesophageal
infections,oftencoexistingwithotheresophagealdiseases.Abouttwo-
thirdsofpeoplewithAIDSandesophagealcandidiasisalsohaveoral
candidiasis.
•Candidaisthefourthmostcommoncauseofbloodstreaminfections
amonghospitalpatientsintheUnitedStates.
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7. Epidemiology
•Occurrence–Worldwide.Candidaalbicansisoftenpartof
thenormalhumanflora.
•Reservoirs–Humans
•Modeoftransmission–
1.contactwithsecretionsorexcretionsofmouth,skin,
vaginaandfeces,frompatientsorcarriers.
2.Passagefrommothertoneonateduringchildbirth.
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8. 1.Incubationperiod–variable.
2.Periodofcommunicability-presumablywhilelesions
arepresent.
3.Susceptibilityandresistance–
i.Susceptibilityisverylowexceptinlowhostdefense.Itis
commonindiabetes,HIVinfected;womenareproneto
vulvovaginitisinthethirdtrimesterofpregnancy.
ii.Oralcontraceptiveusers,individualswithprolonged
steroidtherapyaresusceptible.
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9. Signs and symptoms
1.Signsandsymptomsofcandidiasisvarydependingonthe
areaaffected.
2.Mostcandidalinfectionsresultinminimalcomplications
suchasredness,itching,anddiscomfort,though
complicationsmaybesevereorevenfatalifleftuntreated.
3.Inimmunocompetentpersons,candidiasisisusuallyavery
localizedinfectionoftheskinormucosalmembranes,
includingtheoralcavity(thrush),thepharynxoresophagus,
thegastrointestinaltract,therectum,anus,
perianal/perirectalorano-rectalarea(inmenaswellas
women),theperineum,theurinarybladder,thefingernails
ortoenails(onychomycosis),andthegenitalia
(vagina,penis,etc.).
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10. Signs and symptoms
3.Infectionofthevaginaorvulvamaycausesevereitching,
burning,soreness,irritation,andawhitishorwhitish-
graycottagecheese-likedischarge.
4.Inimmunocompromisedpatients,Candidainfectionscan
affecttheesophaguscausingmoreseriouscondition,called
candidemia.
5.Thrushiscommonlyseenininfants.
6.Children,mostlybetweentheagesofthreeandnine
yearsofage,canbeaffectedbychronicmouthyeast
infections,normallyseenaroundthemouthaswhite
patches.However,thisisnotacommoncondition.
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11. 7)Symptomsofinfectionofthemalegenitalia(balanitisthrush)include
redskinaroundtheheadofthepenis,swelling,irritation,itchiness
andsorenessoftheheadofthepenis,thick,lumpydischargeunder
theforeskin,unpleasantodour,difficultyretractingtheforeskin
(phimosis),andpainwhenpassingurineorduringsex.
8)Esophagealcandidiasiscancausedifficultyswallowing,orless
commonlypainfulswallowing.Abnormalproliferationofthecandida
inthegutmayleadtodysbiosis.
9)Whileitisnotyetclear,thisalterationmaybethesourceof
symptomsgenerallydescribedastheirritablebowelsyndrome,and
othergastrointestinaldiseases.
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Signs and symptoms

12. Clinical manifestation
•Severevulvarpruritis(prominentfeatureAnintenseitching
sensationthatcanhavevariouscauses)
•vaginaldischarge(scanty,whitish,yellow,thicktoform
curds,non-offensive)
•sorevulvaduetoitching
•speculumexamination–thickwhitishplugsattachedto
vaginalwall
•vaginalepitheliumbleedswhentheplugisremovedbutthe
cervixisnormal
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13. Causes
•Aweakenedorundevelopedimmunesystemormetabolic
illnessessuchasdiabetesaresignificantpredisposingfactors
ofcandidiasis.
•Candidayeastsarecommonlypresentinhumans,andtheir
growthisnormallylimitedbythehumanimmunesystemand
byothermicroorganisms,suchasbacteriaoccupyingthe
samelocationsinthehumanbody.
•Diseasesthatincreasetheriskofcandidiasis
includeHIV/AIDS,mononucleosis,cancertreatments,steroi
ds,stress,antibiotics,diabetes,andnutrientdeficiency.
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14. •Pregnancyandtheuseoforalcontraceptiveshavebeen
reportedasriskfactors.
•Diabetesmellitusandtheuseofantibioticsarealsolinkedto
increasedratesofyeastinfections.
•Dietshighinsimplecarbohydrateshavebeenfoundtoaffect
ratesoforalcandidiasis.
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15. Conditions
•Candidainfectionmorelikelytodevelopinsomecases,
including:
-Diabetes,
-HIVinfection,
-Cancer,
-Drymouth,and
-Pregnancy.
•CasesoforalandesophagealcandidiasisinHIV/AIDS
patientswereestimatedat10,347and2950,respectively
inNepalaccordingtomedicalresearchin2015.
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16. Prognosis
•Amongindividualsbeingtreatedinintensivecareunits,
themortalityrateisabout30-50%whensystemiccandidiasis
develops.
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17. Diagnosis
•Basedonclinicalgrounds
•Microscopicdemonstrationofpseudohyphaeoryeastcellsin
infectedtissueorbodyfluids(vaginaldischarge)
•Culture(vaginaldischarge)
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18. Treatment
Candidiasisiscommonlytreatedwithantimycotics;
theseantifungaldrugsinclude:
1.TopicalNystatinVaginalPessaryor
2.MiconazoleOrTopicalClotrimazoleCreamsor
3.TopicalKetoconazoleor
4.Fluconazoleinrecurrentcases
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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
•Adietthatsupportstheimmunesystemandisnothighin
simplecarbohydratescontributestoahealthybalanceofthe
oralandintestinalflora.
•Wearingcottonunderwearmayhelptoreducetheriskof
developingskinandvaginalyeastinfections,alongwithnot
wearingwetclothesforlongperiodsoftime.
•Oralhygienecanhelppreventoralcandidiasiswhenpeople
haveaweakenedimmunesystem.
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Oral Candidiasis (Thrush)

22. Thrush
•Thrushisayeastinfectionof
themucusmembraneliningthe
mouthandtongue.
•Oralinfectionsaremost
commonininfants,elderly
people,andthosewitha
weakened
immunesystem.
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23. Causes
•ThrushiscausedbyformsofafunguscalledCandida.A
smallamountofthisfunguslivesinourmouthmostofthe
time.Itisusuallykeptincheckbyyourimmunesystemand
othertypesofgermsthatalsonormallyliveinyourmouth.
•However,whenourimmunesystemisweak,thefunguscan
grow.
•Thrushiscommonlyseenininfants.Itisnotconsidered
abnormalininfantsunlessitlastslongerthanacoupleof
weeks.
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24. Symptoms
•Thrushusuallydevelopssuddenly,butitmaybecome
chronic,persistingoveralongperiodoftime.
•Acommonsignofthrushisthepresenceofcreamywhite,
slightlyraisedlesionsinyourmouth-usuallyontongue.
•Thelesions,canbepainfulandmaybleedslightlywhen
scrapethemorbrushteeth.
•Inseverecases,thelesionsmayspreadintoyouresophagus,
orswallowingtube,causingpainordifficultyswallowing.
•Thrushcanspreadtootherpartsofthebody,includingthe
lungs,liver,andskin.
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Thrush

26. Treatment
•Medicationsthatinhibitthegrowthoffungi(antifungals)are
thestandardtreatmentforthrush.
•Thesemedicationsareeitherapplieddirectlytotheaffected
area(topical)orswallowed(oral).
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27. Cutaneous candidiasis
•Cutaneouscandidiasisinclude:
•Paronychiaandonychomycosis.
•Diapercandidiasis.
•Intertrigocandidiasis.
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28. Cutaneous candidiasis
Paronychia:-
•Paronychiaofthefingernailsmaydevelopinpersons
whosehandsaresubjecttocontinuouswetting,especially
withsugarsolutionsorcontactwithflour,thatsoftensthe
nailfoldsandcuticle.
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•In chronic cases the
infection may progress to
cause onychomycosiswith
total detachment of the
cuticle from the nail plate.

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Paronychia

30. Cutaneous candidiasis
Diapercandidiasis:-
•Diapercandidiasisiscommonininfantsunderunhygienic
conditionsofchronicmoistureandlocalskinmaceration
associatedwithammoniticirritationduetoirregularly
changeduncleandiapers.
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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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