What is invasive candidiasis. How does Candida spread throughout the body. Who is at risk for systemic yeast infections. What are the symptoms of invasive candidiasis. How is invasive candidiasis diagnosed and treated. Can invasive candidiasis be prevented. What are the long-term effects of systemic Candida infections.

What is Invasive Candidiasis?

Invasive candidiasis is a serious fungal infection caused by Candida yeast that spreads throughout the body. Unlike localized Candida infections like oral thrush or vaginal yeast infections, invasive candidiasis affects the blood, heart, brain, eyes, bones, and other internal organs.

Candida normally lives harmlessly in the mouth, throat, gut, and on the skin. However, in certain at-risk individuals, it can enter the bloodstream and cause a systemic infection. The most common form is candidemia, a Candida bloodstream infection.

Key Facts About Invasive Candidiasis:

• Caused by Candida yeast spreading throughout the body
• Affects the blood and internal organs
• Most common form is candidemia (bloodstream infection)
• A leading cause of bloodstream infections in hospitalized patients
• Can result in lengthy hospital stays and death if left untreated
• Treatable with antifungal medications

How Does Candida Spread Throughout the Body?

Candida yeast typically lives harmlessly on and in the body. However, certain factors can allow it to overgrow and enter the bloodstream, leading to invasive candidiasis:

• Prolonged use of central venous catheters
• Surgical procedures
• Weakened immune system (e.g. from chemotherapy)
• Transmission via healthcare workers’ hands

Once in the bloodstream, Candida can spread to various organs and tissues, causing a systemic infection. This process is known as hematogenous dissemination.

Common Candida Species Causing Invasive Infections:

• Candida albicans
• Candida glabrata
• Candida parapsilosis
• Candida tropicalis
• Candida krusei

Candida auris is an emerging species causing concern due to its increasing prevalence and drug resistance.

Who is at Risk for Invasive Candidiasis?

Certain populations are at higher risk for developing invasive candidiasis:

• Hospitalized patients, especially in intensive care units
• Individuals with weakened immune systems
• Cancer patients undergoing chemotherapy
• Organ transplant recipients
• People with HIV/AIDS
• Premature infants
• Elderly individuals
• Patients with central venous catheters
• Those undergoing major surgeries, especially abdominal surgeries

Understanding these risk factors is crucial for early identification and prevention of invasive candidiasis in vulnerable populations.

What are the Symptoms of Invasive Candidiasis?

Symptoms of invasive candidiasis can vary depending on which organs are affected. Common signs and symptoms include:

• Fever and chills
• Fatigue
• Body aches
• Nausea and vomiting
• Abdominal pain
• Skin rash
• Confusion or altered mental state
• Difficulty breathing
• Vision changes (if eyes are affected)
• Bone and joint pain (if bones are affected)

These symptoms can be non-specific and may mimic other conditions, making diagnosis challenging. Prompt medical attention is crucial if invasive candidiasis is suspected, especially in high-risk individuals.

How is Invasive Candidiasis Diagnosed?

Diagnosing invasive candidiasis requires a combination of clinical assessment, laboratory tests, and imaging studies:

1. Blood cultures: To detect Candida in the bloodstream
2. Tissue biopsy: If organ involvement is suspected
3. Molecular tests: PCR-based methods for rapid detection
4. Imaging studies: CT scans or MRI to identify organ involvement
5. Antigen tests: To detect Candida antigens in blood or other body fluids

Early diagnosis is critical for timely treatment and improved outcomes. Healthcare providers should maintain a high index of suspicion in at-risk patients presenting with compatible symptoms.

Challenges in Diagnosing Invasive Candidiasis:

• Non-specific symptoms
• Similarity to bacterial infections
• Limited sensitivity of blood cultures
• Difficulty obtaining tissue samples from deep-seated infections

Treatment Options for Invasive Candidiasis

Treatment of invasive candidiasis typically involves antifungal medications. The choice of drug, duration, and route of administration depend on the severity of infection, organ involvement, and patient factors.

Common Antifungal Medications:

• Echinocandins (e.g., caspofungin, micafungin, anidulafungin)
• Azoles (e.g., fluconazole, voriconazole, posaconazole)
• Amphotericin B (used in severe cases or when resistance is suspected)

Treatment duration typically ranges from weeks to months, depending on the extent of infection and clinical response. In some cases, combination therapy may be used for severe or resistant infections.

Additional Treatment Measures:

• Removal of infected central venous catheters
• Surgical debridement of infected tissues
• Management of underlying conditions
• Supportive care (e.g., fluid management, pain control)

Regular monitoring of treatment response through clinical assessment, blood cultures, and imaging studies is essential to guide therapy and detect complications.

Prevention Strategies for Invasive Candidiasis

Preventing invasive candidiasis involves a multifaceted approach, particularly in healthcare settings:

1. Hand hygiene: Proper hand washing and use of alcohol-based sanitizers by healthcare workers
2. Catheter care: Proper insertion, maintenance, and timely removal of central venous catheters
3. Antibiotic stewardship: Judicious use of antibiotics to prevent Candida overgrowth
4. Antifungal prophylaxis: For high-risk patients (e.g., certain cancer patients, transplant recipients)
5. Environmental cleaning: Regular disinfection of hospital surfaces
6. Patient education: Teaching at-risk individuals about prevention measures

Implementing these strategies can significantly reduce the incidence of invasive candidiasis, particularly in healthcare-associated infections.

Challenges in Prevention:

• Emerging drug-resistant Candida species
• Balancing antifungal prophylaxis with the risk of resistance
• Maintaining consistent adherence to infection control practices
• Identifying and managing asymptomatic Candida colonization

Long-term Effects and Prognosis of Invasive Candidiasis

The long-term effects and prognosis of invasive candidiasis can vary widely depending on several factors:

• Timing of diagnosis and treatment initiation
• Extent of organ involvement
• Underlying health conditions
• Candida species and antifungal susceptibility
• Adequacy of source control (e.g., catheter removal, abscess drainage)

Mortality rates for invasive candidiasis remain high, ranging from 15-35% for candidemia and potentially higher for deep-seated infections. Survivors may experience prolonged hospital stays, increased healthcare costs, and potential long-term complications.

Possible Long-term Effects:

• Organ dysfunction (e.g., kidney damage, liver problems)
• Neurological sequelae (if central nervous system involvement)
• Vision impairment (in cases of endophthalmitis)
• Chronic pain or mobility issues (if bone/joint involvement)
• Increased risk of recurrent infections

Long-term follow-up and management of these potential complications are crucial for improving outcomes in survivors of invasive candidiasis.

Emerging Challenges in Invasive Candidiasis Management

As our understanding of invasive candidiasis evolves, several challenges have emerged in its management:

1. Antifungal Resistance

The rise of antifungal-resistant Candida species, particularly C. auris, poses a significant threat. This emerging pathogen is often multidrug-resistant and can cause outbreaks in healthcare settings. Developing new antifungal agents and implementing effective infection control measures are crucial to address this challenge.

2. Diagnostic Limitations

Current diagnostic methods for invasive candidiasis have limitations in sensitivity and speed. Developing more rapid and accurate diagnostic tools, such as molecular-based assays and biomarker tests, is an active area of research to improve early detection and treatment.

3. Host Factors and Personalized Medicine

Understanding how host genetic factors influence susceptibility to invasive candidiasis and treatment response is an emerging field. This knowledge could lead to more personalized approaches to prevention and treatment, tailoring interventions based on individual risk profiles.

4. Biofilm Formation

Candida species can form biofilms on medical devices and tissues, making infections more challenging to treat. Research into anti-biofilm strategies and novel treatment approaches is ongoing to address this issue.

5. Immunomodulatory Therapies

Exploring the potential of immunomodulatory therapies to enhance host defense against Candida infections is an area of active investigation. These approaches could complement traditional antifungal treatments, particularly in immunocompromised patients.

6. Global Surveillance and Epidemiology

Improving global surveillance systems for invasive candidiasis is crucial to track emerging species, monitor antifungal resistance patterns, and inform public health interventions. International collaboration and data sharing are essential in this effort.

Addressing these challenges requires a multidisciplinary approach involving clinicians, researchers, public health officials, and policymakers. Continued research, innovation, and collaboration are essential to improve the prevention, diagnosis, and treatment of invasive candidiasis in the future.

About Invasive Candidiasis | Invasive Candidiasis | Candidiasis | Types of Diseases | Fungal Diseases

What is invasive candidiasis?

Medical illustration of Candida albicans.

Invasive candidiasis is an infection caused by a yeast (a type of fungus) called Candida.  Unlike Candida infections in the mouth and throat (also called “thrush”) or vaginal “yeast infections,” which are localized to one part of the body,  invasive candidiasis is a serious infection that can affect the blood, heart, brain, eyes, bones, or other parts of the body.¹

Candida normally lives inside the body (in places such as the mouth, throat, gut, and vagina) and on the skin without causing any problems.² However, in certain patients who are at risk, Candida can enter the bloodstream or internal organs and cause an infection. A Candida bloodstream infection, also called candidemia, is the most common form of invasive candidiasis. ¹ In the United States, candidemia is one of the most common causes of bloodstream infections in hospitalized patients,^3–4 and it often results in long hospital stays and death. It is also responsible for high medical costs.⁵

Antifungal medication can treat invasive candidiasis. Certain patients such as those with cancer or bone marrow or organ transplants might receive antifungal medication to prevent invasive candidiasis.⁶

1. Kullberg BJ, Arendrup MC. Invasive candidiasisexternal icon. N Engl J Med 2015; 373:1445-1456.
2. Nucci M, Anaissie E. Revisiting the source of candidemia: skin or gut?external icon Clin Infect Dis. 2001 Dec 15;33(12):1959-67.
3. Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance studyexternal icon. Clin Infect Dis. 2004 Aug 1;39(3):309-17.
4. Magill SS, O’Leary E, Janelle S, Thompson DL, Dumyati G, Nadle J, et al. Changes in prevalence of health care–associated infections in U.S. hospitalsexternal icon. N Engl J Med 2018; 379:1732-44.
5. Morgan J, Meltzer MI, Plikaytis BD, Sofair AN, Huie-White S, Wilcox S, et al. Excess mortality, hospital stay, and cost due to candidemia: a case-control study using data from population-based candidemia surveillanceexternal icon. Infect Control Hosp Epidemiol 2005 Jun;26(6):540-7.
6. Pappas PG, Kauffman CA, Andes DR, Clark CJ, Marr KA, Ostrosky-Zeichner L, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of Americaexternal icon. Clin Infect Dis 2016;62:e1-50.

Page last reviewed: February 2, 2021

Content source: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Foodborne, Waterborne, and Environmental Diseases (DFWED)

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• Fungal Meningitis
• National Center for Emerging and Zoonotic Infectious Disease
• Division of Foodborne, Waterborne, and Environmental Diseases
• Mycotic Diseases Branch

Where Invasive Candidiasis Comes From | Invasive Candidiasis | Candidiasis | Types of Diseases | Fungal Diseases

Candida lives in and on the body

Candida, the fungus that causes invasive candidiasis, normally lives inside the body (in places such as the mouth, throat, gut, and vagina) and on the skin without causing any problems.¹ In some people who are at higher risk for the infection, Candida can enter the bloodstream or internal organs and cause invasive candidiasis. For example, this can happen when a central venous catheter is inserted and left in place for a long time, during surgery, or when the immune system is weakened during chemotherapy. Healthcare workers can also carry Candida on their hands. ^2,3 A few outbreaks of candidemia have been linked to healthcare workers’ hands,^4,5 so hand hygiene in healthcare settings is important for preventing the spread of infections.

Types of

Candida

There are over hundreds of species of Candida, but only a few are known to cause infections.⁶ The most common species that cause infections are C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, and C. krusei.

Another species called C. auris is emerging as a cause of invasive candidiasis around the world and in certain areas of the United States – read more about this concerning and often drug-resistant species.

1. Nucci M, Anaissie E. Revisiting the source of candidemia: skin or gut?external icon Clin Infect Dis. 2001 Dec 15;33(12):1959-67.
2. Strausbaugh LJ, Sewell DL, Ward TT, Pfaller MA, Heitzman T, Tjoelker R. High frequency of yeast carriage on hands of hospital personnelexternal icon. J Clin Microbiol. 1994 Sep;32(9):2299-300.
3. Yildirim M, Sahin I, Kucukbayrak A, Ozdemir D, Tevfik Yavuz M, Oksuz S, et al. Hand carriage of Candida species and risk factors in hospital personnelexternal icon. Mycoses. 2007 May;50(3):189-92.
4. Lupetti A, Tavanti A, Davini P, Ghelardi E, Corsini V, Merusi I, et al. Horizontal transmission of Candida parapsilosis candidemia in a neonatal intensive care unitexternal icon. J Clin Microbiol. 2002 Jul;40(7):2363-9.
5. Clark TA, Slavinski SA, Morgan J, Lott T, Arthington-Skaggs BA, Brandt ME, et al. Epidemiologic and molecular characterization of an outbreak of Candida parapsilosis bloodstream infections in a community hospitalexternal icon. J Clin Microbiol. 2004 Oct;42(10):4468-72.
6. Pappas PG. Invasive candidiasisexternal icon. Infect Dis Clin North Am. 2006 Sep;20(3):485-506.

Page last reviewed: December 29, 2020

Content source: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Foodborne, Waterborne, and Environmental Diseases (DFWED)

Enter your email to get updates on C. auris

• Fungal Meningitis
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• Division of Foodborne, Waterborne, and Environmental Diseases
• Mycotic Diseases Branch

Thrush in women – symptoms and treatment in St. Petersburg

How the disease develops: causes and pathogenesis

Normally, the mucous membrane of the external genitalia is not sterile. The microflora of the vagina includes friendly microorganisms, including the Candida fungus, which serve as the body’s defense against infection. Under adverse conditions, when the microbiome is disturbed, the fungus spreads rapidly, causing the characteristic symptoms of thrush. In some cases, the underlying tissues and blood vessels are also involved in the pathological process, which carry the fungus throughout the body.

The causes of thrush in women are varied:

• Taking medications – antibacterial drugs, cytostatics, glucocorticosteroids, immunosuppressants.

• Decrease in general immunity against the background of chronic diseases – diabetes mellitus, pyelonephritis, blood diseases, tonsillitis, metabolic disorders.

• Changes in the hormonal background due to pathologies of the female genital area, pregnancy, hypothyroidism, the use of oral contraceptives.

• Stress factors – climate change, nervous tension, physical and emotional overload.

• Errors in matters of personal hygiene – untimely change of pads and tampons, the use of aggressive cleansers (violate the natural pH level of the vagina).

• The presence of injuries of the mucous membrane, provoked by wearing tight underwear, sexual intercourse with a deficiency of natural lubrication.

Often, a decrease in local immunity is caused by malnutrition, hypothermia, vitamin deficiency, and untreated sexually transmitted diseases.

Signs of candidiasis

Vaginal candidiasis is called “thrush” because of the characteristic cheesy discharge that accompanies the spread of fungal colonies. In some cases, the discharge may be absent or change its character depending on the phase of the menstrual cycle.

Another striking sign of candidiasis is itching and burning in the intimate area. Itchy sensations are so unbearable that they significantly worsen the quality of life of a woman. Itching increases in the morning, before menstruation, after hygiene procedures and sexual intercourse.

Other symptoms of thrush:

• burning and pain during urination;

• soreness during intimate contacts;

• pungent sour smell of discharge.

If the disease becomes chronic, relapses of fungal infections of the external genital organs occur more often than four times a year. Recurrent candidiasis has an erased clinical picture, when signs of pathology are present, but weakly expressed.

With complicated thrush, the pathological process is more difficult. Deeper tissues are affected, ulcerations and cracks are observed on the vaginal mucosa.

How candidiasis is diagnosed

The treatment of vaginal candidiasis is preceded by a comprehensive diagnosis. The disease in women can be diagnosed already during the initial gynecological examination. The mucous membrane of the vagina looks edematous and inflamed. The natural pink color of the fabrics changes to bright scarlet. Specific discharges of white or yellowish color with grains resembling cottage cheese are found.

With a complicated fungal infection, vesicles appear on the skin of the external genital organs. These are small blisters filled with a cloudy or clear liquid. They are able to open, exposing the epidermis and provoking the development of erosion.

To confirm the diagnosis, medical laboratory tests are carried out:

• smear microscopy – examination of the microflora of the vagina under a microscope;

• bakposev secretions – allows you to accurately detect the fungus-causative agent;

• PCR and ELISA of genital secretions for the detection of Candida albicans antigens;

• complete blood count – helps to see the inflammatory process.

Diagnosis is complicated if thrush occurs against the background of sexually transmitted diseases – chlamydia, gonorrhea, trichomoniasis. Therefore, an accurate diagnosis and development of a treatment plan for candidiasis in women is the prerogative of a doctor.

Methods of treatment

It is recommended to contact the clinic at the first signs of thrush – itching and specific discharge. Self-medication can lead to the fact that the symptoms will be masked, and the fungal disease will become recurrent. Dealing with it will be much more difficult, and the likelihood of complications will only increase.

Treatment methods for thrush will include both medications and medications aimed at normalizing the microflora. Doctors mainly focus on antifungal medications containing nystatitis, fluconazole, clotrimazole, nitrofungin, ketoconazole. They disrupt the synthesis of substances contained in the membrane of the fungus, which inhibits the growth of colonies or leads to the complete destruction of the pathogen. Preparations for candidal lesions of the mucous membranes are available in the form of tablets, capsules, suppositories, ointments and creams. The drug is selected individually, taking into account the clinical picture.

The program of complex treatment of candidiasis also includes:

It is important to eliminate the cause of the pathology in order to prevent the occurrence of relapses. Funds may be required to improve hormonal levels, fight dysbacteriosis and sexually transmitted diseases.

It is recommended to adjust the diet – reduce the consumption of sweets and carbohydrates. They serve as a breeding ground for the active development of the fungus and slow down recovery.

Of the physiotherapeutic methods for the treatment of thrush, darsonvalization, laser therapy, electrophoresis, and magnetotherapy contribute. During therapy and after it, it is necessary to adhere to the basic principles for the prevention of microflora disorders:

• abandon tight synthetic underwear in favor of comfortable cotton;

• timely treat common diseases – hormonal, inflammatory, infectious;

• change tampons and pads more often during menstruation;

• refuse “daily”;

• do not take antibiotics without a doctor’s prescription;

• use special means for intimate hygiene;

• when carrying out antibacterial therapy, in parallel, use means to restore normal microflora.

Do not treat candidiasis as a harmless disease. The inflammatory process caused by the fungus can spread to surrounding organs and tissues. Against the background of weakened immunity, a bacterial infection easily joins a fungal infection, which is fraught with the development of salpingitis, adnexitis, urethritis, cystitis. Only competent treatment of thrush in the clinic “MEDIONA PARNAS” is the key to a successful recovery and preservation of women’s health.

Itching of the skin all over the body, ointment for itching

THERE ARE CONTRAINDICATIONS. POSSIBLE SIDE EFFECTS. A SPECIALIST’S CONSULTATION IS REQUIRED. 49 When to prescribe antipruritic ointments for the skin

Itching is an unpleasant symptom that has a variety of causes. Antipruritic ointments for the skin help to fight it. But you can use drugs only after examination and establishing the exact cause of the itching. Otherwise, the use of these funds will not only not be beneficial, but will also cause a deterioration in the condition.

When antipruritic ointments are prescribed for the skin

Itching of the skin is caused by:

• skin pathologies (most common cause) – eczema, dermatitis, psoriasis;
• allergies;
• infectious and fungal diseases – chickenpox, ringworm, candidiasis;
• general pathologies – diabetes, liver disease, varicose veins;
• prolonged sun exposure, dry skin;
• psychological state – depression, anxiety;
• hormonal changes during pregnancy and menopause;
• insect bites, contact with parasites (scabies, pediculosis).

Antipruritic ointment is selected based on the symptoms and the cause of its occurrence. There are several categories of drugs:

• Antihistamines – reduce itching, swelling and redness. Relief occurs within a few minutes after application.
• Corticosteroids – for the treatment of skin diseases. Applies for a limited period of time.
• Local anesthetics – contain novocaine and lidocaine, which desensitize the skin. Relieve minor itching.
• Calcineurin inhibitors – relieve the inflammatory process.

Menthol and camphor oil are used in folk medicine. They cool the skin and soothe itching.

You might be interested in: Today’s Best Allergy Remedy

Itchy Foot Ointments

Itchy feet are caused by fungus, food allergies, dust, clothes, skin conditions, and infections. One of the reasons for its appearance is inadequate hygiene.

The list of the best ointments includes:

1. Advantan – suppresses allergies and inflammation. It is used to treat neurodermatitis, eczema, atopic dermatitis.
2. Sinaflan – has anti-allergic and anti-inflammatory properties. Indicated for dry skin, allergic manifestations, insect bites.
3. Elokom – relieves inflammation and itching, has a vasoconstrictive effect. It is prescribed for dermatitis, allergic skin lesions, for the treatment of lichen.

Be sure to consult your doctor if, despite all the measures taken, the symptom continues to bother you for more than 2 weeks, prevents you from sleeping at night, itching begins to spread throughout the body.

Facial products

Eruptions and itching on the face can appear as a result of allergies caused by cosmetics, changes in the state of the body, past illnesses, under the influence of stress. The skin of the face is especially sensitive and delicate, therefore, for its treatment, the means are selected with extreme care.

It is preferable to choose non-hormonal ointments for therapy. They have a mild effect. But, unfortunately, non-hormonal remedies do not cope with severe forms of allergic dermatoses. In these cases, hormonal preparations (ointment, cream, balm) are prescribed, which can quickly alleviate the condition. However, these drugs have many contraindications, so you can not choose the drug yourself and use it uncontrollably.

Genital preparations

An unpleasant symptom in the genital area occurs in both men and women. It can be caused by external influences, infections, violations of hygiene rules. Often occurs with diseases of the internal genital organs.

For the intimate area are used:

1. Oxycort – eliminates itching caused by allergies, dermatitis, insect bites, infected diaper rash.
2. Hydrocortisone ointment – used to treat psoriasis, dermatitis, eczema.
3. Prednisalone ointment – reduces symptoms caused by eczema, dermatitis.
4. Mirtoplex, Biopin, Acyclovir are used to treat genital herpes. The drugs effectively relieve itching, as they fight its cause.

Thrush often develops as a reaction to antibiotics, stress, malnutrition.