Candida

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is Candida?

Candida is the scientific name for a genus of fungi. Candida infections, also called candidiasis, are often referred to as yeast or fungal infections. When they occur in the mouth and throat, Candida infections are called thrush. The most common sites of infection include the mouth and throat, the genitals, and moist skin folds. Candida can also cause a systemic, or body-wide, infection, but this is very rare, occurring in less than 0.1% of cases every year in the United States (Source: CDC).

Candida can cause inflammation in the infected tissues. Cutaneous, or skin, Candida infections tend to appear as red, weepy, scaly areas. Candida infections can also cause pus-filled bumps. In the mouth and throat, the infection often forms thick, white patches. Genital Candida infections often produce a thick, white vaginal discharge.

Candida occurs naturally in the environment and may also be present on skin surfaces, in the mouth and digestive tract, and in the vagina without causing problems. However, infections can occur in otherwise healthy people when they take antibiotics or have areas of skin that are constantly moist. People with weakened immune systems are at higher risk of developing Candida infections, including systemic infections.

Treated appropriately, Candida infections often resolve, although they may recur.

Candida infections are rarely serious or life threatening unless they are systemic infections. Seek immediate medical care (call 911) for serious symptoms, such as fever and chills that don’t improve, confusion, lethargy, loss or change in level of consciousness, seizure, decreased urine output, rapid heart rate, chest pain, severe abdominal pain, and unusual irritability or poor feeding in a child.

Seek prompt medical care if you have never had a Candida infection before and believe you have one, if you are being treated for Candida but symptoms recur or are persistent, or if you have any other concerns. Also seek prompt medical care if you have fevers and chills that are not responsive to therapy or have difficulty swallowing.

What are the symptoms of Candida?

Symptoms of Candida depend on the site of infection. Cutaneous Candida infections, on the skin surface, tend to appear as red, weepy, scaly areas. Candida infections can also cause pus-filled bumps. In the mouth and throat, the infection often forms thick, white patches. Genital Candida infections often produce a thick, white vaginal discharge. Some diaper rashes are caused by Candida.

Systemic Candida infections produce nonspecific symptoms such as fever and chills. Other symptoms can occur and tend to be related to the organs involved.

Common symptoms of cutaneous Candida

Cutaneous (skin) Candida infections have some characteristic features including:

  • Feeling of warmth in the affected area
  • Itchy skin
  • Lesions in moist areas such as under skin folds
  • Lesions that cluster and run together
  • Pus-filled bumps
  • Red, inflamed, weepy skin
  • Scalloped borders around the skin lesions
  • Scaly areas over the reddened skin

Common symptoms of thrush

Candida can cause infection and inflammation in the mouth, nasal passages, and throat, which is known as thrush, or oropharyngeal candidiasis. Symptoms of thrush include:

  • Burning feeling or painful sensation in the mouth or on the tongue
  • Difficulty swallowing
  • Redness
  • Splitting or cracking of the corners of the mouth (angular cheilitis)
  • Thickened white patches visible inside the mouth and on the tongue

Common symptoms of genital Candida

Although it is more common in women, genital candidiasis also occurs in men. Symptoms of genital Candida infection include:

  • Burning feeling or feeling of warmth in the affected area
  • Itching feeling
  • Pain during sexual intercourse
  • Pain with urination
  • Red, inflamed, weepy skin
  • Scalloped borders around the skin lesions
  • Scaly areas over the reddened skin
  • Swelling
  • Thick, white vaginal discharge with a texture similar to cottage cheese

Common symptoms of systemic Candida

Systemic Candida infections do not always causes symptoms. When they do, the symptoms may be nonspecific unless a particular organ is involved. Symptoms of systemic Candida infections include:

Serious symptoms that might indicate a life-threatening condition

In some cases, Candida can cause life-threatening infections. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

What causes Candida?

Although various species of Candida can cause infection, most infections are caused by Candida albicans. Candida infections are generally not considered contagious. Candida is present in the environment and can be carried by healthy people without causing symptoms.

People with weakened immune systems have the highest risk of developing candidal infections. These tend to develop in the brain, the esophagus, as well as disseminated infection throughout the body. Antibiotic and corticosteroid treatments can increase the risk of genital infections in women, as can pregnancy and diabetes.

Hospitalized individuals admitted to the Intensive Care Unit (ICU) are at greatest risk for developing candidiasis due to the presence of indwelling intravenous lines, feeding tubes, urinary catheters and respiratory ventilatory tubes – all of which provide a direct pathway for infection.

What are the risk factors for Candida infection?

A number of factors increase the risk of developing cutaneous Candida infections. Not all people with risk factors will get Candida infections. Risk factors for cutaneous Candida infection include:

  • Diabetes

  • Diaper use

  • Obesity

  • Weakened immune system, such as occurs in people who have AIDS (acquired immunodeficiency syndrome), are undergoing cancer treatment, or have had an organ transplant

A number of factors increase the risk of developing oral candidiasis, or thrush, including:

  • Advanced age

  • Denture use

  • Infancy

  • Treatment with corticosteroids

  • Weakened immune status

A number of factors increase the risk of developing genital Candida infections including:

  • Antibiotics

  • Diabetes

  • Oral contraceptives

  • Pregnancy

  • Treatment with corticosteroids

  • Weakened immune status

Systemic Candida infections are uncommon, but certain people have a higher risk than others. Risk factors for systemic Candida infections include:

  • Kidney failure

  • Prolonged catheter use

  • Prolonged hospitalization

  • Prolonged mechanical ventilation

  • Prolonged treatment with antibiotics or corticosteroids

  • Severe trauma or burns

  • Surgery

  • Very low birth weight and preterm babies

  • Weakened immune status

Reducing your risk of Candida

You can reduce your risk of developing a Candida infection by:

  • Avoiding the use of douches and feminine hygiene sprays, perfumes, and powders

  • Changing baby diapers frequently

  • Eating yogurt with live cultures while taking antibiotics

  • Keeping your blood sugar levels under control

  • Keeping your skin clean and dry

  • Losing weight if you are overweight

  • Practicing good hygiene

  • Using a soft toothbrush

  • Using body powders to absorb moisture

  • Washing with warm water only and avoiding scented soaps or wipes

  • Wearing loose, airy clothing

How is Candida treated?

Treatment for Candida typically involves the use of antifungal medications, although oral thrush in babies often goes away on its own. The type of antifungal therapy depends on the site and severity of the infection, and whether any past treatment was effective. Antifungal medications may be topical, oral or intravenous.

Topical antifungal medications used to treat Candida

Topical antifungal medications can be used for cutaneous candidiasis, thrush, or genital candidiasis. Topical antifungal agents used for these conditions include:

  • Butoconazole (Femstat) vaginal cream

  • Clotrimazole (Lotrimin, Mycelex) topical cream, vaginal cream, or vaginal suppositories

  • Clotrimazole lozenges

  • Ketoconazole (Nizoral) topical cream

  • Miconazole (Micatin, Monistat) topical cream or vaginal cream

  • Nystatin “swish and swallow” oral suspension

  • Tioconazole (Vagistat) vaginal cream

Oral antifungal medications used to treat Candida

Oral antifungal drugs may be used for cutaneous candidiasis, thrush, or genital candidiasis, especially for infections that are more severe or that fail to resolve with topical treatment, or for systemic Candida infections. Oral antifungal medications used to treat Candida infections include:

  • Fluconazole (Diflucan)

  • Ketoconazole (Nizoral)

  • Voriconazole (Vfend)

Intravenous antifungal medications used to treat Candida

Systemic candidiasis is often treated with intravenous antifungal medications including:

  • Amphotericin B

  • Anidulafungin (Eraxis)

  • Caspofungin (Cancidas)

  • Fluconazole (Diflucan)

  • Micafungin (Mycamine)

  • Voriconazole (Vfend)

It is important for you to complete the entire course of treatment to prevent recurrence and reduce the risk of complications of Candida infections. Also, it is possible for Candida to become resistant to antifungal medications. Completing the entire course of medication as recommended and using antifungal medications only when a candidal or other fungal infection is present helps prevent antifungal resistance.

What you can do to improve your Candida

In addition to managing your risk factors, you can also soothe some of the symptoms of your Candida infection by:

  • Applying warm compresses on genital infections and gently patting the area dry afterward

  • Avoiding scratching or picking at the infected areas

  • Taking over-the-counter pain relief medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)

  • Using over-the-counter hydrocortisone creams temporarily as needed for itching

What are the potential complications of Candida?

Complications of Candida infections, particularly those that are systemic, can be serious, even life threatening in some cases. People with weakened immune systems have the highest risk of complications. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of Candida infection include:

  • Abscess formation in the spleen

  • Arthritis

  • Encephalitis (brain inflammation)

  • Esophagitis (inflammation or infection of the esophagus)

  • Endophthalmitis (inflammation or infection inside the eye)

  • Inflammation and infections of the heart, such as endocarditis (inflammation of the heart valves and lining), myocarditis (infection of the middle layer of the heart wall), and pericarditis (infection of the lining that surrounds the heart)

  • Malnutrition

  • Meningitis (infection or inflammation of the sac around the brain and spinal cord)

  • Peritonitis (infection of the lining that surrounds the abdomen)

  • Recurrent or persistent infection

  • Secondary infection of skin lesions

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 9
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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  3. Pappas PG, Kauffman CA, Andes D, et al. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 2009; 48:503.