What is invasive candidiasis. How does Candida affect the body. Which patients are at risk for invasive candidiasis. What are the symptoms of a systemic yeast infection. How is invasive candidiasis diagnosed and treated. Can invasive candidiasis be prevented. What are the different types of Candida that cause infections.

What is Invasive Candidiasis?

Invasive candidiasis is a severe fungal infection caused by Candida species that spreads throughout the body. Unlike localized Candida infections like oral thrush or vaginal yeast infections, invasive candidiasis can affect multiple organs and systems, including the blood, heart, brain, eyes, and bones.

Candidemia, a Candida bloodstream infection, is the most common form of invasive candidiasis. In the United States, it ranks among the leading causes of bloodstream infections in hospitalized patients. This serious condition often results in extended hospital stays, high medical costs, and can be life-threatening if not treated promptly.

The Origins of Invasive Candidiasis

Candida fungi naturally reside in various parts of the human body, including the mouth, throat, gut, and vagina, as well as on the skin. In healthy individuals, these fungi coexist harmlessly with other microorganisms. However, certain risk factors can disrupt this balance, allowing Candida to overgrow and invade the bloodstream or internal organs.

How does Candida enter the bloodstream?

• Prolonged use of central venous catheters
• Surgical procedures
• Weakened immune system due to chemotherapy or other medical conditions
• Transmission via healthcare workers’ hands

Maintaining proper hand hygiene in healthcare settings is crucial for preventing the spread of Candida infections.

Common Candida Species Causing Infections

While there are hundreds of Candida species, only a handful are known to cause infections in humans. The most prevalent species responsible for invasive candidiasis include:

1. Candida albicans
2. Candida glabrata
3. Candida parapsilosis
4. Candida tropicalis
5. Candida krusei

A emerging concern is Candida auris, a species that has been causing outbreaks of invasive candidiasis worldwide. C. auris is particularly worrisome due to its frequent resistance to multiple antifungal drugs.

Risk Factors for Invasive Candidiasis

Certain individuals are at higher risk for developing invasive candidiasis. Understanding these risk factors is essential for prevention and early detection.

Who is most susceptible to invasive candidiasis?

• Patients with weakened immune systems (e.g., HIV/AIDS, cancer)
• Recipients of organ or bone marrow transplants
• Individuals undergoing chemotherapy
• Patients in intensive care units
• Premature infants
• Elderly individuals with multiple medical conditions
• People with diabetes
• Patients on broad-spectrum antibiotics

Healthcare providers often consider prophylactic antifungal treatment for high-risk patients to prevent invasive candidiasis.

Symptoms of Invasive Candidiasis

The symptoms of invasive candidiasis can vary depending on which organs are affected. However, some common signs may indicate a systemic Candida infection.

What are the typical symptoms of invasive candidiasis?

• Fever and chills that don’t respond to antibiotic treatment
• Low blood pressure
• Rapid heart rate
• Difficulty breathing
• Kidney failure
• Skin lesions
• Vision changes (if the eyes are affected)
• Abdominal pain

It’s important to note that these symptoms can be similar to those of other infections, making diagnosis challenging without proper testing.

Diagnosis of Invasive Candidiasis

Diagnosing invasive candidiasis requires a combination of clinical assessment and laboratory tests. Early and accurate diagnosis is crucial for effective treatment.

How is invasive candidiasis diagnosed?

• Blood cultures to detect Candida in the bloodstream
• Tissue biopsies from affected organs
• Imaging studies (CT scans, MRI) to identify organ involvement
• Molecular diagnostic tests (PCR) for rapid detection of Candida DNA
• Serum biomarker tests (e.g., β-D-glucan assay)

Healthcare providers may use a combination of these methods to confirm the diagnosis and determine the extent of the infection.

Treatment Approaches for Invasive Candidiasis

Treating invasive candidiasis typically involves a multifaceted approach, combining antifungal medications with supportive care.

What are the primary treatment options for invasive candidiasis?

• Antifungal medications (e.g., echinocandins, azoles, amphotericin B)
• Removal of infected medical devices (such as catheters)
• Surgical intervention to remove infected tissue, if necessary
• Supportive care to manage complications and organ dysfunction

The choice of antifungal medication depends on the Candida species identified, the patient’s condition, and any drug resistances. Treatment duration typically ranges from weeks to months, depending on the severity and extent of the infection.

Prevention Strategies for Invasive Candidiasis

Preventing invasive candidiasis is crucial, especially in healthcare settings and for high-risk individuals. Several strategies can help reduce the risk of infection.

How can invasive candidiasis be prevented?

• Proper hand hygiene for healthcare workers and patients
• Appropriate use and timely removal of central venous catheters
• Judicious use of broad-spectrum antibiotics
• Antifungal prophylaxis for high-risk patients
• Maintaining good overall health and a strong immune system
• Regular monitoring of high-risk patients for early signs of infection

Implementing these preventive measures can significantly reduce the incidence of invasive candidiasis, particularly in healthcare settings.

Emerging Concerns: Candida auris

Candida auris has emerged as a significant global health threat in recent years. This species presents unique challenges in the fight against invasive candidiasis.

Why is Candida auris a growing concern?

• Multidrug resistance, making treatment difficult
• Ability to spread rapidly in healthcare settings
• Challenges in identification using standard laboratory methods
• Persistence on surfaces, leading to environmental contamination
• Potential for causing outbreaks in healthcare facilities

Healthcare facilities must implement strict infection control measures to prevent the spread of C. auris and other drug-resistant Candida species.

Long-term Impact of Invasive Candidiasis

Invasive candidiasis can have significant long-term effects on survivors, even after successful treatment.

What are the potential long-term consequences of invasive candidiasis?

• Increased risk of recurrent infections
• Organ damage or dysfunction
• Chronic fatigue and weakness
• Cognitive impairment (if the central nervous system was affected)
• Prolonged recovery time and rehabilitation needs
• Psychological impact, including anxiety and depression

Long-term follow-up care and support are essential for patients who have recovered from invasive candidiasis to address these potential complications.

Research and Future Directions

Ongoing research in the field of invasive candidiasis aims to improve prevention, diagnosis, and treatment strategies.

What are the current areas of focus in invasive candidiasis research?

• Development of new antifungal drugs to combat resistant strains
• Improvement of rapid diagnostic techniques
• Investigation of host-pathogen interactions to identify new therapeutic targets
• Exploration of immunotherapy approaches
• Studies on the microbiome and its role in Candida colonization and invasion
• Development of vaccines against Candida infections

These research efforts hold promise for enhancing our ability to prevent and treat invasive candidiasis more effectively in the future.

Global Impact of Invasive Candidiasis

Invasive candidiasis is a worldwide health concern, with varying incidence and impact across different regions.

How does invasive candidiasis affect different parts of the world?

• Higher incidence in developing countries due to limited healthcare resources
• Variations in predominant Candida species by geographic region
• Differences in antifungal resistance patterns globally
• Economic burden on healthcare systems, particularly in resource-limited settings
• Challenges in implementing prevention and control measures in diverse healthcare environments

International collaboration and standardization of practices are crucial for effectively combating invasive candidiasis on a global scale.

The Role of the Immune System in Candida Infections

The immune system plays a critical role in preventing and fighting Candida infections. Understanding this relationship can lead to improved therapeutic approaches.

How does the immune system interact with Candida?

• Innate immune responses provide the first line of defense against Candida
• Adaptive immunity develops specific antibodies and T-cell responses
• Immune dysregulation can lead to increased susceptibility to invasive candidiasis
• Certain immune cells (e.g., neutrophils, macrophages) are crucial for controlling Candida growth
• Cytokines and other signaling molecules coordinate the immune response

Research into immune mechanisms against Candida may lead to novel immunotherapeutic strategies for preventing and treating invasive candidiasis.

Antifungal Resistance: A Growing Challenge

The development of antifungal resistance in Candida species poses a significant challenge in treating invasive candidiasis.

What factors contribute to antifungal resistance?

• Overuse or inappropriate use of antifungal drugs
• Genetic mutations in Candida species
• Formation of biofilms that protect fungi from antifungal agents
• Emergence of naturally resistant Candida species
• Cross-resistance between different classes of antifungal drugs

Addressing antifungal resistance requires a multifaceted approach, including stewardship programs, development of new drugs, and improved diagnostic techniques to guide targeted therapy.

Invasive Candidiasis in Special Populations

Certain populations require special consideration when it comes to invasive candidiasis due to unique risk factors or treatment challenges.

How does invasive candidiasis affect different patient groups?

• Neonates: Higher risk due to immature immune systems and frequent use of invasive medical devices
• Pregnant women: Increased susceptibility and potential risks to the fetus
• Elderly patients: Age-related immune decline and multiple comorbidities increase risk
• Solid organ transplant recipients: Immunosuppression and surgical complications contribute to higher incidence
• HIV/AIDS patients: Opportunistic Candida infections are common, especially in advanced disease stages

Tailored prevention and treatment strategies are essential for managing invasive candidiasis in these vulnerable populations.

In conclusion, invasive candidiasis remains a significant global health challenge, particularly in healthcare settings and among vulnerable populations. Ongoing research, improved diagnostic techniques, and the development of new antifungal therapies offer hope for better outcomes in the future. However, prevention through proper hygiene practices, judicious use of antibiotics, and targeted prophylaxis for high-risk individuals remains crucial in the fight against this serious fungal infection. As our understanding of Candida biology and host-pathogen interactions deepens, we can expect more effective strategies for managing and preventing invasive candidiasis to emerge.

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
• National Center for Emerging and Zoonotic Infectious Disease
• 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.