Yeast infection throughout body. Invasive Candidiasis: Understanding Systemic Yeast Infections

07.08.202309.07.2023 by alexxlab

What are the causes of invasive candidiasis. How does Candida spread throughout the body. Who is at risk for developing a systemic yeast infection. What are the symptoms and treatment options for invasive candidiasis.

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What is Invasive Candidiasis?

Invasive candidiasis is a serious fungal infection caused by yeasts belonging to the Candida genus. Unlike localized Candida infections such as oral thrush or vaginal yeast infections, invasive candidiasis occurs when Candida enters the bloodstream or internal organs, potentially affecting the blood, heart, brain, eyes, bones, and other parts of the body.

Candida normally resides in the body without causing harm, living in areas like the mouth, throat, gut, and vagina, as well as on the skin. However, in certain high-risk individuals, Candida can invade deeper tissues and cause a systemic infection.

Key Facts About Invasive Candidiasis:

It’s most commonly caused by Candida albicans, though other species can be involved
Candidemia (Candida in the blood) is the most frequent form of invasive candidiasis
It’s a leading cause of bloodstream infections in hospitalized patients
The infection can result in prolonged hospital stays and high mortality rates
Treatment typically involves antifungal medications

Common Causes and Risk Factors for Invasive Candidiasis

While Candida is a normal part of the human microbiome, certain factors can disrupt the balance and allow these fungi to overgrow and invade deeper tissues. Understanding these risk factors is crucial for prevention and early intervention.

What conditions increase the risk of invasive candidiasis?

Prolonged use of broad-spectrum antibiotics
Weakened immune system (e.g., due to HIV/AIDS, cancer treatments, or organ transplantation)
Diabetes mellitus, especially when poorly controlled
Central venous catheters or other medical devices that breach natural barriers
Major surgery, particularly abdominal surgery
Severe burns or other extensive skin damage
Prolonged stay in intensive care units
Neutropenia (low neutrophil count) often associated with cancer treatments

Healthcare settings play a significant role in the transmission of Candida. Healthcare workers’ hands can carry the fungi, emphasizing the importance of proper hand hygiene protocols in medical facilities.

Recognizing the Symptoms of Invasive Candidiasis

Identifying invasive candidiasis early can be challenging as symptoms may be nonspecific and mimic other conditions. However, prompt recognition is crucial for timely treatment and improved outcomes.

What are the common signs and symptoms of invasive candidiasis?

Fever and chills that don’t respond to antibiotics
Low blood pressure (hypotension)
Rapid heart rate (tachycardia)
Difficulty breathing or shortness of breath
Organ-specific symptoms depending on the site of infection (e.g., vision changes if eyes are affected)
Skin lesions or rashes in some cases

It’s important to note that these symptoms can vary widely depending on the affected organs and the patient’s overall health status. In severely immunocompromised individuals, symptoms may be more subtle or atypical.

Diagnosis and Testing for Invasive Candidiasis

Diagnosing invasive candidiasis requires a combination of clinical assessment, laboratory tests, and imaging studies. Early and accurate diagnosis is crucial for initiating appropriate treatment.

How is invasive candidiasis diagnosed?

Blood cultures: The primary method for detecting candidemia
Tissue biopsies: May be necessary to diagnose organ-specific infections
Molecular diagnostic tests: PCR-based methods for rapid detection of Candida DNA
Imaging studies: CT scans, MRI, or ultrasound to identify organ involvement
Biomarker tests: Detecting Candida antigens or antibodies in blood or other fluids

Physicians often start empiric antifungal therapy in high-risk patients with suspected invasive candidiasis while awaiting definitive diagnostic results, as delays in treatment can significantly impact outcomes.

Treatment Approaches for Invasive Candidiasis

Effective management of invasive candidiasis involves prompt initiation of antifungal therapy, often in combination with supportive care and addressing underlying risk factors.

What are the primary treatment options for invasive candidiasis?

Echinocandins: First-line therapy for most cases (e.g., caspofungin, micafungin)
Azoles: Used in certain situations or as step-down therapy (e.g., fluconazole, voriconazole)
Amphotericin B: Reserved for severe cases or when other options are ineffective
Removal of infected medical devices (e.g., central venous catheters)
Surgical intervention may be necessary for certain localized infections

Treatment duration varies depending on the extent of infection, the patient’s response, and underlying conditions. Typically, therapy continues for at least 2 weeks after the last positive blood culture and resolution of symptoms.

Prevention Strategies for Invasive Candidiasis

Preventing invasive candidiasis involves a multifaceted approach, focusing on risk reduction and infection control measures, particularly in healthcare settings.

How can the risk of invasive candidiasis be minimized?

Implement strict hand hygiene protocols in healthcare facilities
Judicious use of antibiotics to prevent disruption of normal flora
Proper care and timely removal of central venous catheters
Antifungal prophylaxis for high-risk patients (e.g., certain cancer patients, transplant recipients)
Maintain good glycemic control in diabetic patients
Enhance infection control measures in intensive care units
Regular screening of high-risk patients for early detection

Healthcare institutions should develop and adhere to comprehensive infection prevention strategies, including staff education and regular audits of compliance with best practices.

Emerging Threats: Candida auris and Drug Resistance

The landscape of invasive candidiasis is evolving, with new challenges emerging in recent years. One significant concern is the rise of Candida auris, a species first identified in 2009 that has since spread globally.

Why is Candida auris a major concern in healthcare settings?

High levels of antifungal resistance, including multi-drug resistant strains
Ability to persist in the environment and spread easily in healthcare facilities
Difficulties in identification using standard laboratory methods
Associated with high mortality rates in infected patients
Potential for causing outbreaks in healthcare settings

The emergence of C. auris highlights the importance of ongoing surveillance, rapid diagnostic capabilities, and the development of new antifungal agents to combat resistant strains.

Long-term Impacts and Complications of Invasive Candidiasis

While the immediate focus in invasive candidiasis is often on acute management and survival, the infection can have significant long-term consequences for survivors.

What are potential long-term effects of invasive candidiasis?

Increased risk of recurrent Candida infections
Organ damage, particularly to the kidneys or liver
Cognitive impairment in cases of CNS involvement
Prolonged recovery and rehabilitation periods
Psychological impacts, including post-traumatic stress disorder
Increased healthcare utilization and costs

Long-term follow-up and support are crucial for patients who have recovered from invasive candidiasis, addressing both physical and psychological aspects of recovery.

Understanding invasive candidiasis is essential for healthcare providers and at-risk individuals alike. As fungal infections continue to pose significant challenges in medical settings, ongoing research, improved diagnostic tools, and novel treatment approaches will be crucial in combating this serious condition. By staying informed about risk factors, prevention strategies, and emerging threats like Candida auris, we can work towards reducing the incidence and impact of invasive candidiasis in vulnerable populations.

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

Kullberg BJ, Arendrup MC. Invasive candidiasisexternal icon. N Engl J Med 2015; 373:1445-1456.
Nucci M, Anaissie E. Revisiting the source of candidemia: skin or gut?external icon Clin Infect Dis. 2001 Dec 15;33(12):1959-67.
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.
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.
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.
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.

Nucci M, Anaissie E. Revisiting the source of candidemia: skin or gut?external icon Clin Infect Dis. 2001 Dec 15;33(12):1959-67.
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.
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.
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.
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.
Pappas PG. Invasive candidiasisexternal icon. Infect Dis Clin North Am. 2006 Sep;20(3):485-506.

Page last reviewed: December 29, 2020

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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.

Types of thrush.!

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What is candidiasis, oral candidiasis
Candidiasis of the genitals in women and men
Candidiasis in young children
Invasive candidiasis or candidemia

1. What is candidiasis, oral candidiasis

Candidiasis, simply called thrush, is traditionally considered a vaginal disease of women, but it is not. The fungus that causes candidiasis can affect the skin, genitals, nasopharynx, and even blood.

Thrush is caused by the growth of Candida. These fungi are always present in the body, but in small quantities.

Symptoms and treatment depend on the part of the body that is affected.

Oral candidiasis

Oral candidiasis is most common in newborns, older people who have received chemotherapy, and other groups of people with weakened immune systems. It also occurs in people with diabetes or those who take antibiotics or inhalers for asthma along with steroids.

Common symptoms include:

White patches on mouth and tongue;
Redness or discomfort in the mouth;
Sore throat and difficulty swallowing;
Cracks in the corners of the mouth.

Treatment consists of taking a drug that kills the fungus. The preparation may be in the form of a tablet or rinse. In advanced cases, intravenous antifungal drugs are used.

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2. Candidiasis of the genitals in women and men

Candidiasis of the genitals, what is usually meant by thrush, is more common in women. Symptoms include:

Vaginal irritation and redness;
White cheesy vaginal discharge;
Pain during sex.

Genital thrush also occurs in men. Men with circumcision are least affected by thrush. Thrush in men has the following symptoms:

Red rash on the penis;
Burning and itching of the head.

There are many over-the-counter remedies for genital thrush: creams, ointments, and intravaginal suppositories. There are also drugs for oral administration.

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