Candidiasis is a fungal infection caused by a yeast belonging to the Candida species. Candida albicans is the commonest organism that leads to this infection.
The yeast is normally present over skin and mucus membranes.
Since the organism may affect various parts of the body symptoms may vary and range in severity. (1, 2, 3, 4, 5)
Symptoms of Oral Candidiasis
When the mouth and throat are infected there is common occurrence of creamy white or yellow plaques or patches on the insides of the cheeks, gums or on the tongue.
The plaques can be scraped off but may leave a painful, tender, red area underneath, which may bleed.
Sometimes back of the throat may also be involved. There may be pain, soreness, difficulty in swallowing, difficulty in speaking and swelling.
The corners of the mouth may be cracked, fissured and painful. This is called angular cheilitis.
Symptoms of Esophageal Candidiasis
Esophageal candidiasis leads to severe difficulty in swallowing and speaking. There may be nausea, vomiting, pain in the upper parts of the abdomen etc.
Symptoms of Vulvovaginal Candidiasis
In women there may be burning, itching and stinging of the vaginal entrance. Sometimes this is accompanied by creamy white cottage cheese like vaginal discharge.
There may be pain during sexual intercourse and stinging on urination.
Severe cases may show up with red and swollen vagina and vulva, oozing or fissured and cracked skin around the vulva, bleeding etc.
Symptoms of Penile Candidiasis
Penile candidiasis or balanitis manifests as swelling and an itchy rash over the penis especially over the glans penis or tip of the penis.
The infection may spread to groins and other skin folds as well.
Sometimes an allergy to the candida may also occur. This leads to red, itchy spots immediately after contact with an infected area.
Cutaneous or Skin Candidiasis
This affects the folds of the skin especially the warm and moist areas like armpits, groin etc. There are red itchy patches with blisters or patches.
Nail Candidiasis
Paronychia and onychomycosis affect the nails of fingers and toes. They occur in people who work with too much water and those with diabetes mellitus
Symptoms of Invasive Candidiasis
There are no specific manifestations. Some patients may develop fever with chills and tremors.
Once the infection has spread to other organs symptoms affecting the organs like liver, kidneys, bones, eyes, joints, spleen etc. may show up.
If the infection is not controlled vital organs may stop functioning leading to multi organ failure.
Respiratory Tract Candidiasis
This occurs in patients who have been hospitalized. Infection may spread to the voice box or larynx and may also affect the trachea and bronchi (wind pipes) or lungs.
The condition is called Candia tracheobronchitis or Candia pneumonia respectively. This needs urgent treatment.
Bladder and Urogenital Candidiasis
Candida may also invade the urinary bladder. This leads to urgency and pain or bleeding and discharge on urination. There may be pain over the lower abdomen as well.
Candida Endocarditis
Sometimes candida may infect the heart as well.
This is seen among intravenous heroin users, those on chemotherapy for cancers, those with a prosthetic heart valve or those with a central venous line.
There may be fever, severe fall of blood pressure etc.
Candida Endophthalmitis
Candia species may infect the eye as well. This may occur after eye surgery or after injury of the eye or spread via blood stream in invasive candidiasis.
There may be eye pain, inability to look into light (photophobia), floaters or black spots in vision, blurring of vision, fever etc.
Renal or Hepatic Candidiasis
Renal and Hepatic disease features are seen. Diagnosis may be made only with analysis of blood, urine and biopsy.
Central nervous system infections with Candida
The infection may come from external sources like after surgery, spinal tap or lumbar puncture etc. or may come from invasive candida infection.
This leads to meningitis, abcesses, fever, cerebral inflammation etc. There may be stiffness of the neck (nuichal rigidioty), confusion and even coma.
Candida arthritis and Candida infections of bones and joints
Invasive candidiasis may affect bones, joints and muscles as well. Ribs, long bones, back bone, breast bone etc. may be affected.
There may be localized pain or a discharging site over the bone.
Further Reading
Understanding the mechanisms behind rising antifungal drug resistance