Thursday, 23 August 2012

Thrush (Candidiasis)

Thrush (candidiasis) - commonly referred to as a yeast infection - is a fungal infection of any of a number of species of yeasts (candida). These yeast infections can range in severity, from simple and superficial infections of the mouth and genitals, to more severe and potentially life-threatening systemic infections.

Despite being an infectious disease, it is worth noting that humans may possess one of the many types of candida species of yeast without "breaking out" with an infection. It is normal for a person to contain small amounts of yeast in their intestines and on their skin, where it is usually kept under control by healthy immune system responses as well as other types of bacteria occupying the same area.

Yeast infections of the mouth and genitals are common in most human populations across the world, with more severe infections being far more rare. Due to the number of different types of yeast (candida) species involved in such infections, the term "yeast infection" can refer to one of 13 different types of infection that have varying causes and outcomes. In certain forms, thrush is a noted and wide spread sexually transmitted infection.

In 2006, it was estimated that candida infections were responsible for around 60% of all fungal infections acquired in US hospitals, killing 1 in 3 people with a bloodstream infection.

Signs and Symptoms

Symptoms of cadidiasis vary based on the area infected, although most infections result in such minimal symptoms as redness, itching and discomfort. In immunocompotent patients - those displaying a normal immune system response - cadidiasis is generally a localized infection of the skin or mucosal membranes, such as the mouth, the pharynx or eosophagus, the bladder, or the genitals. It can effect the eosophagus, which carries the risk of becoming a systemic infection. Systemic candidiasis can lead to candidemia, a much more severe form of infection with more complex complications.

Candidiasis is also a common infection in infants, but is not considered abnormal unless its duration is greater than 3 weeks.

Candidiasis is a highly common cause of vaginal infections (vaginitis), and can also lead to penile infection. Infection of the vagina can lead to mild discomfort caused by itching, burning and soreness, as well as a whitish discharge commonly described as being "like cottage cheese". Male infections, which are more uncommon, can display with discomfort caused by itching and burning, sores near the head of the penis, and - more rarely - a white discharge.

Diagnosis and Treatment

To diagnose a yeast infection will usually require microscopic examination of a sample, or culturing. For microscopic examination a scraping or swab will be taken of the infected area, and placed on a slide to be examined under a microscope. For culturing, a sterile swab is rubbed across the infected area, and then streaked on a culture medium, where it will reside for several days at a controlled temperature to allow for development of the yeast colonies.

Once a successful diagnosis has been made, treatment is usually quite straightforward. For example, in confirmed cases of vaginal infection a single, 150-mg dose of fluconazole taken orally has been reported as being 90% effective at treating the infection. Fluconazole is only effective in cases of vaginal infection, and other antimyotic and antifungal drugs will be prescribed for infections of other areas of the body. These can include clotrimazole, and topical ketoconazole.

A specific type of candida species - C. albicans - has shown a resistance to antmycotic drugs. Repeat infections will require treatment with alternating antifungal drugs, but it may also develop resistance to this treatments as well.



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