Candidiasis

Candidiasis

Candidiasis is the most commonly occurring yeast infection caused by a type of fungus named Candida with the species Candida albicans named as the most prevalent. ^[1] These species normally reside on the skin and mucous membrane however when there is an overgrowth, an individual may observe the related symptoms. Candidiasis occurring along the mouth or throat area is referred to as thrush. Virtually any part of the body can be affected. ^[2]

Epidemiology

Candidiasis commonly affects patients who are immunocompromised such as HIV patients. About 90% of HIV positive patients who are not in active medication develop candidiasis usually in the form of thrush. ^[3]

Causes

Aside from an immunocompromised state, certain causes have been identified including intake of drugs like antibiotics and some contraceptive pills, obesity, bacterial infection, diabetes and psoriasis. ^[4]

Signs and Symptoms

A person with candidiasis may notice creamy white lacy patches on the tongue, throat or anywhere in the mouth area. The infection can also come in form of skin lesions such as rashes or blisters in the groin, breast area or in between the fingers. Vaginal itching coupled with white thick discharge may indicate vaginal yeast infection. There may also be pain felt during urination or during sexual intercourse. When the species gets into the blood, the person may develop fever or mental alterations depending on the site of infection. ^{[4] [1]}

Diagnosis

A high index of suspicion is required to diagnose candidiasis. Laboratory studies are often nonspecific. The species obtained from affected area such as skin, mouth or vaginal mucosa may be directly observed under microscope. Blood cultures and urinalysis may also be helpful in disseminated cases. In respiratory tract candidiasis, sputum cultures may be ordered to demonstrate the organisms. ^[3]

Treatment

The patient is prescribed with medications depending on the location of the infection. Antifungal medications vary and may be in the form of oral rinses, vaginal tablet or cream. Corticosteroids may be added in combination to lessen inflammation. Duration of treatment typically runs in days up to 2weeks. Those with severe type of Candida infection may be given intravenous drug. ^[1]

References:

1. http://www.emedicinehealth.com/candidiasis_yeast_infection/article_em.htm
2. http://www.cdc.gov/fungal/candidiasis/
3. http://emedicine.medscape.com/article/213853-overview#a0199
4. http://www.umm.edu/altmed/articles/candidiasis-000030.htm

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Tea Tree Oil [1, 15, 16, 17, 18, 19, 20, 21, 22, 23]:

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present. WARNING: Tea Tree Oil is not recommended for children, pregnant women or mothers that are breastfeeding. Also, Tea tree oil should never be taken internally. Should only be used over skin, inhaled with a vaporizer, or mixed with water as a mouthwash.)

Recommendation: weakly in favor (Laboratory studies have shown that tea tree oil may be effective in treating candida. However more research needs to be done in the form of clinical trials)

Grade of Evidence: low quality of evidence

Sodium Bicarbonate (Baking Soda, Simoncini Cancer Therapy) [1, 13, 14]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (Available evidence does not support claims that baking soda helps to treat candidiasis in any way.)

Grade of Evidence: moderate quality of evidence

Goldenseal (Hydrastis Canadensis) [1, 6, 7, 8, 9, 10, 11, 12]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly against (There is insufficient evidence to support claims that Goldenseal helps to treat candida. More studies are needed. Goldenseal may produce toxic effects, including depression, constipation, rapid heartbeat, stomach pain, mouth ulcers and vomiting.)

Grade of Evidence: low quality of evidence

Cloves (Caryophyllum Aromaticum, Eugenia Caryophyllata) [1, 2, 3, 4, 5]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: weakly in favor  (evidence suggests that Cloves may help treat candidiasis, but more research is needed)

Grade of Evidence: low quality of evidence

Cats Claw (Uncaria Tomentosa):

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: no recomendation (insufficient evidence to support claims that Cats Claw can help to treat candida)

Grade of Evidence: very low quality of evidence

* www.gradeworkinggroup.org

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