Medical News Today: About Candida albicans: Natural yeast and problematic infections

What is Candida albicans?

Candida albicans is part of our natural microflora — or the microorganisms that commonly live in or on our bodies. It can be found in the GI tract, the mouth, and the vagina.

Most of the time it causes no issues, but it’s possible for overgrowths and infections to happen.

Candida albicans is the most prevalent cause of fungal infections in people. Its species name, albicans, comes from the Latin word for “white.” The yeast appears white when cultured on a plate. And in the case of certain infections, like thrush, it can create white patches.

We look more closely at types of Candida albicans infections and how they’re treated.


Types of Candida albicans infections

Below, we’ll explore the causes, symptoms, and treatment of four of the most common types of Candida infection. In the next section we’ll go over the less common infections that Candida albicans can also cause.

Urinary yeast infection

Candida species are the most common cause of fungal urinary tract infections (UTIs). Candida UTIs can occur in the lower portion of the urinary tract or in some cases can ascend up to the kidneys.

The following can put you at risk of developing a Candida UTI:

  • having taken a course of antibiotics
  • having a medical device inserted, such as a urinary catheter
  • diabetes
  • a weakened immune system

Symptoms

Many people with a Candida UTI don’t have symptoms. If symptoms are present, they can include:

  • an increased need to urinate
  • a painful or burning sensation when urinating
  • abdominal or pelvic pain
  • blood in your urine

Treatment

Treatment is only recommended for symptomatic individuals. The antifungal drug fluconazole can be used in many cases.

If a catheter is in place, it should be removed.

Genital yeast infection

Candida albicans is the most common cause of genital yeast infections.

Normally, a type of bacteria called Lactobacillus keeps the amount of Candida in the genital area under control. However, when Lactobacillus levels are disrupted in some way, Candida can overgrow and cause an infection.

You can also develop a Candida genital infection after participating in certain sexual activities, particularly those that involve oral-genital contact.

Although otherwise healthy individuals can get genital Candida infections, the following groups are at an increased risk:

  • people that have taken antibiotics recently
  • people with uncontrolled diabetes
  • immunosuppressed individuals
  • pregnant women
  • people that are taking oral contraceptives or who are on hormone therapy

Symptoms

Symptoms of a genital Candida infection can include:

  • a burning feeling while having sex or while urinating
  • an itchy or painful feeling in or around the vagina
  • redness, irritation, or swelling around the vagina
  • abnormal vaginal discharge that can be either watery, or thick and white
  • a rash around the vagina
  • a rash on the penis

Candida species can also infect the male genitals, often if their partner has a vaginal Candida infection. The infection may be asymptomatic, but can cause an itchy or burning rash around the head of the penis.

Treatment

Mild or moderate genital Candida infections can be treated with a short course of an over-the-counter (OTC) or prescription antifungal cream, pill, or suppository. You could also be prescribed a single dose of an oral antifungal medication, such as fluconazole.

For more complicated infections, you may be prescribed a longer course of medication, either in the form of a cream, a pill, or an ointment.

Oral thrush

Despite being a normal part of the microflora of your mouth, Candida albicans can cause infections if it overgrows. The infection may not be limited to just your mouth. It can spread to your tonsils and the back of your throat as well.

Severe infections may spread to the esophagus.

People that are at an increased risk for developing oral thrush include:

  • those taking antibiotics or corticosteroid drugs
  • someone with undiagnosed or uncontrolled diabetes
  • immunosuppressed individuals
  • those who wear dentures, particularly upper dentures

Symptoms

Some of the common symptoms of oral thrush include:

  • white spots in your mouth that have the appearance of cottage cheese and may bleed when touched
  • a burning or painful sensation in your mouth
  • redness inside your mouth or at the corners of your mouth
  • difficulty with eating or swallowing
  • loss of taste
  • a cotton-like feeling inside your mouth

If an oral thrush infection is left untreated, it can lead to a systemic Candida infection, particularly in people with a weakened immune system.

Treatment

Oral thrush is treated with an antifungal medication that can come in the form of a pill, liquid, or lozenge. Examples of drugs that are used include nystatin or clotrimazole.

An oral course of fluconazole can be given for more severe cases.

Mucocutaneous candidiasis

candida albicans
Candida albicans is the most common cause of fungal skin infections.

Candida species can also infect your skin and mucus membranes.

Candida albicans is most often the cause of a fungal skin infection, although other Candida strains can also cause it.

Areas that are warm, moist, or sweaty provide good environments for yeast to thrive. Examples of such areas include the armpits, groin, the skin between your fingers and toes, the corners of your mouth, and the area under your breasts.

Other risk factors for developing a Candida skin infection include:

  • wearing tight or synthetic undergarments
  • having poor hygiene or changing undergarments infrequently, including infrequent diaper changes for infants
  • taking antibiotics or corticosteroid drugs
  • having diabetes
  • having a weakened immune system

Symptoms

The most common symptom of a Candida skin infection is a red rash that forms in the affected area.

In some cases, blister-like lesions can form. The skin may also become thickened or produce a white substance that has a curd-like appearance.

Treatment

Antifungal creams are typically given to clear the skin infection. They can contain antifungal drugs such as clotrimazole, miconazole, and econazole.

A steroid cream may also be given to help ease any itching or swelling. The skin should also be kept dry while recovering.

In cases where the infection is widespread, oral fluconazole pills may be prescribed.

How are Candida infections diagnosed?

In order to diagnose candidiasis, your doctor will first take your medical history and ask you about your symptoms. They may also ask if you have any conditions or medications that could lead to a weakened immune system, or if you’ve taken a course of antibiotics recently.

Many common cases of candidiasis can often be diagnosed through a physical examination.

If your doctor is uncertain if your symptoms are due to a Candida infection, they may take a sample from the affected area. This sample can then be used to culture the organism and to identify what species it is. For example, if candidemia is suspected, your doctor will collect a blood sample for testing.

Identifying the species of Candida that’s causing your infection is also helpful because your doctor will be able to prescribe an antifungal medication that will be effective in treating that particular species.



Other Candida infections

If Candida albicans enter your bloodstream, they can cause serious infections not only in your blood but in other organs as well.

Neutropenia — a key risk factor

An important risk factor for developing more invasive Candida conditions is neutropenia. This is when there are abnormally low levels of cells called neutrophils in your blood. It can make you more prone to infections.

People that are commonly affected by neutropenia include people undergoing chemotherapy or radiation therapy for cancer, and people with leukemia or other bone marrow diseases.

Individuals that have neutropenia and an invasive Candida infection have different treatment recommendations.


Candidemia

Candidemia is a blood infection with Candida species. It can lead to long hospital stays and an increase in mortality due to concurrent conditions.

Risk factors for candidemia include:

  • immunosuppression
  • use of broad-spectrum antibiotics
  • major surgery
  • placement of a medical device such as a feeding tube or catheter

Symptoms

Symptoms can resemble those of bacterial sepsis and can include:


Diagnosis and treatment

Candidemia can be diagnosed when the yeast is isolated from a blood sample.

Treatment may depend on the species of Candida causing the infection, but can include IV doses of fluconazole, caspofungin, micafungin, or amphotericin B. Catheters should also be removed.

Endocarditis

Endocarditis is an infection of the inner lining of your heart, which includes the heart chambers and valves.

Fungal endocarditis is a very serious condition with a high mortality rate. Candida albicans is responsible for 24 to 46 percent of all cases of fungal endocarditis.

Risk factors for developing this condition include:

  • a weakened immune system
  • heart abnormalities or defects
  • prolonged antibiotic use
  • cardiovascular surgery
  • implantation of medical devices, such as a feeding tube, catheter, or prosthetic heart valves

Symptoms

Symptoms of fungal endocarditis can include:

  • fever
  • cough
  • difficulty breathing
  • generalized body pain, sometimes in the lower extremities

Diagnosis and treatment

Diagnosis can be difficult because symptoms are often similar to endocarditis caused by bacteria.

Treatment may include intravenous (IV) fluconazole or amphotericin B, removal of any infected medical device, and possible surgical removal of fungus from the tissue.

Endophthalmitis

Endophthalmitis is an inflammation of the eye that can be caused by fungus. It can lead to loss of vision.

Candida albicans is the most common Candida species involved, although Candida tropicalis can also cause the infection.

Risk factors for endophthalmitis are:

  • recent hospitalization
  • recent surgery
  • a weakened immune system
  • having a medical device such as a catheter or IV inserted

Symptoms

The condition can affect one or both eyes. The main symptom is inflammation in the eye, although in some cases pus can be present in the tissues of the eye.

Diagnosis and treatment

Endophthalmitis can be diagnosed through a retinal examination as well as by analyzing a sample of fluid from your eye.

Treatment can include amphotericin B with flucytosine. Fluconazole can also be used.


Meningitis

Meningitis is the inflammation of the tissues that surround your brain and spinal cord. Fungal meningitis can occur when fungus travels through the blood to your spinal cord. Fungal meningitis caused by Candida is often acquired within a hospital.

Factors that can put you at risk for meningitis caused by Candida can include:

  • immunosuppression
  • certain medications such as antibiotics, immunosuppressants, or corticosteroids
  • a recent surgical procedure

Symptoms

Symptoms of fungal meningitis include:

  • headache
  • stiff neck
  • fever
  • nausea and vomiting
  • sensitivity to light
  • confusion

Diagnosis and treatment

If a fungus is suspected for causing your meningitis, a sample of cerebral spinal fluid (CSF) will be taken and cultured.

The recommended treatment of meningitis caused by Candida species is amphotericin B with flucytosine.

Intra-abdominal candidiasis

Intra-abdominal candidiasis can also be referred to as Candida peritonitis. It’s an inflammation of the lining of your inner abdomen caused by a yeast infection.

The condition is most commonly caused by Candida albicans although other Candida species can cause it as well.

Some risk factors for developing intra-abdominal candidiasis include:

  • a recent abdominal surgery or procedure
  • undergoing peritoneal dialysis
  • antibiotic therapy
  • conditions such as diabetes

Symptoms

The symptoms of intra-abdominal candidiasis can be very similar, if not indistinguishable, from bacterial peritonitis. Symptoms can include:

  • pain or bloating in your abdomen
  • fever
  • nausea and vomiting
  • feeling tired or fatigued
  • diarrhea
  • diminished appetite

In order to diagnose the condition, your doctor will take a sample of abdominal fluid (peritoneal fluid). If Candida is causing the infection, yeast will be observed in the sample.

Treatment

Treatment can include antifungal drugs such as:

  • fluconazole
  • amphotericin B
  • caspofungin
  • micafungin

Catheters should be removed as well.

Osteomyelitis and fungal arthritis

Osteomyelitis is a bone infection while fungal arthritis (also called septic arthritis) is a fungal infection of a joint. Both conditions can be caused by Candida species, although this is rare. Bacterial infections are more common.

Risk factors for developing these conditions can include:

  • having a weakened immune system
  • experiencing a recent bone injury or orthopedic procedure
  • having an IV or a catheter
  • conditions such as diabetes

Symptoms

Symptoms of these conditions include pain or swelling in the affected area that can be accompanied by fever or chills. People with fungal arthritis can also have great difficulty using the affected joint.

In order to determine if a fungal infection is causing osteomyelitis, a bone biopsy may be needed. Analysis of joint fluid can determine if arthritis is due to a fungal infection.

If a blood infection caused either condition, Candida may also be detected in the blood.

Treatment

Treatment can include courses of antifungal medication such as amphotericin B and fluconazole.


Candida albicans and you

Normally, Candida species are a part of the natural microflora of the GI tract, skin, and vagina, and don’t cause disease. Some circumstances, such as taking a long course of antibiotics or having a weakened immune system can increase your risk of developing a Candida infection.

The most common Candida infections, such as vaginal and skin infections, are localized and can be treated with antifungal drugs. An untreated Candida infection carries the risk of leading to a systemic infection in which other organs can become involved.

If you notice symptoms that are consistent with those of a Candida infection, see your doctor in order to receive the proper diagnosis and treatment.

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