candidiasis

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Definition

Candidiasis is an infection caused by a species of the yeast Candida, usually the Candida albicans fungus. Candida is found on various parts of the bodies of almost all normal people but causes problems in only a few. Candidiasis can affect the skin, nails, and mucous membranes throughout the body including the mouth (thrush), esophagus, vagina (yeast infection), intestines, and lungs.

Description

Candida may cause yeast mouth infections (also known as thrush) in children with reduced immune function or in children taking certain antibiotics. Antibiotics may upset the balance of microorganisms in the body and allow an overgrowth of Candida. The use of inhaled steroids for the treatment of asthma has also been shown to cause oral candidiasis. Many infants acquire candidiasis from their mothers during the process of birth, when the baby comes in contact with naturally existing Candida found in the mother's vagina. Candidiasis is not considered harmful to infants unless it lasts more than several weeks after birth. These yeast mouth infections cause creamy white, curd-like patches on the tongue, inside of the mouth, and on the back of the throat. Under the whitish material, there are red lesions that may bleed.

Candida also may infect an infant's diaper rash, as it grows rapidly on irritated and moist skin. Children who suck their thumbs or other fingers may also develop candidiasis around their fingernails, causing redness on the nail edges.

Candida is a common cause of vaginal infections in adolescent girls, especially when the normal populations of the bacteria Lactobacilli have been reduced due to antibiotic use, allowing the overgrowth of Candida. A candidiasis infection in the vagina results in itching, burning, soreness, and a thick, white vaginal discharge.

Other risk factors for candidiasis include obesity, heat, and excessive sweating that result in the formation of moist skin areas where the yeast organism can grow.

In the early 2000s, several serious categories of candidiasis have become more common, due to overuse of antibiotics, the rise of AIDS, the increase in incidence of organ transplantations, the use of chemotherapy in cancer treatment, and the implantation of invasive devices (e.g., nasogastric tubes, catheters, and artificial joints and valves) into the body—all of which increase a patient's susceptibility to infection. Diabetics are especially susceptible to candidiasis, as they have high levels of sugar in their blood and urine and a low resistance to infection, both of which are conditions that favor the growth of yeast. Also known as invasive candidiasis, deep organ candidiasis is a serious systemic infection that can affect the esophagus, heart, blood, liver, spleen, kidneys, eyes, and skin. Like vaginal and oral candidiasis, it is an opportunistic disease that strikes when a child's resistance is lowered, often due to another illness. Children with granulocytopenia (deficiency of white blood cells) are particularly at risk for deep organ candidiasis. There are many diagnostic categories of deep organ candidiasis, depending on the tissues involved.

In the past candidiasis was referred to as moniliasis.

Demographics

Candidiasis is an extremely common infection. Thrush occurs in approximately 2–5 percent of healthy newborns and occurs in a slightly higher percentage of infants during their first year of life.

Over 1 million adult women and adolescent girls in the United States develop vaginal yeast infections each year. It is not life-threatening, but the condition can be uncomfortable and frustrating.

Causes and Symptoms

Candidiasis is caused by a species of the yeast Candida, usually the Candida albicans fungus.

In oral candidiasis, the disease is characterized by whitish patches that appear on the tongue, inside of the cheeks, or on the palate. Pain or difficulty in swallowing may indicate a fungal infection in the throat, which is a potential complication of AIDS. Most adolescent girls with vaginal candidiasis experience severe vaginal itching and have a discharge that often looks like cottage cheese and has a sweet or bread-like odor. The vulva and vagina can be red, swollen, and painful. The infected skin in diaper rash that includes infection with Candida appears fiery red with areas that may have a raised red border.

Effects of deep organ or systematic candidiasis include meningitis, arthritis, fungemia (fungi in the blood, causing fever and possibly leading to sepsis), endocarditis (heart infection), endophthalmitis (infection and scarring in the eye that can affect vision), and renal or bladder bezoars (colonization and blockage of the urinary tract by Candida, which can cause urinary tract infections and kidney failure.

Diagnosis

Often clinical appearance and visual examination give a strong suggestion about the diagnosis. Generally, a doctor takes a sample of the vaginal discharge or swabs an area of oral or skin lesions, and then inspects this material under a microscope, where it is possible to see characteristic forms of yeasts at various stages in the lifecycle.

Fungal blood and stool cultures for detection of the Candida organism should be taken for patients suspected of having deep organ candidiasis. Tissue biopsy may be needed for a definitive diagnosis.

When to Call the Doctor

The doctor should be called if a child exhibits any symptoms of the various types of candidiasis.

Treatment

Treatment of candidiasis is primarily accomplished through the use of antifungal drugs. Oral candidiasis is usually treated with prescription lozenges or mouthwashes. Some of the most-used prescriptions are nystatin mouthwashes (Nilstat or Nitrostat) and clotrimazole lozenges. Skin infections can be treated with topical antifungal creams. Highly inflamed skin lesions can also be treated with corticosteroid creams.

For infants with oral candidiasis, pacifiers should be sterilized or discarded. Bottle nipples should be discarded and new ones used as the infant's mouth begins to heal.

The risk of diaper rash complicated with candidiasis can be reduced by preventing irritating dermatitis through the use of absorbent diapers and prevention of excessive exposure to urine or feces through frequent changing of diapers. The use of plastic pants that do not allow air circulation over the diaper area is not recommended. Children may still attend child care; however, childcare providers should follow good hygienic practices, including thorough hand washing and disposal of materials that may contain nasal and oral secretions of infected children, in order to prevent transmitting the infection to other children.

In most cases, vaginal candidiasis can be treated successfully with a variety of over-the-counter antifungal creams or suppositories, including Monistat, Gyne-Lotrimin, and Mycelex. However, infections often recur. If an adolescent girl has frequent recurrences, she should consult her doctor about prescription drugs such as Vagistat-1, Diflucan, and others.

The early 2000s increase in deep organ candidiasis has led to the creation of treatment guidelines, including, but not limited to, the following:

• Catheters should be removed from children with candidiasis.
• Antifungal therapy may be used during chemotherapy to prevent candidiasis.
• Drugs should be prescribed based on a child's specific history and immune defense status (this is especially critical for children with AIDS). Stronger antifungal drugs, such as ketoconazole or fluconazole, may be necessary.
• Diabetes mellitus should be controlled with appropriate medication and dietary changes.

Alternative Treatment

Home remedies for vaginal candidiasis include vinegar douches or insertion of a paste made from Lactobacillus acidophilus powder into the vagina. In theory, these remedies make the vagina more acidic and, therefore, less hospitable to the growth of Candida. Fresh garlic (Allium sativum) is believed to have antifungal action, so incorporating it into the diet or inserting a gauze-wrapped, peeled garlic clove into the vagina may be helpful. The insert should be changed twice daily. Some women report success with these remedies; however, they should try a conventional treatment if an alternative remedy is not effective.

Prognosis

Oral and skin candidiasis, though painful, are usually cured with the use of antifungal medications. However, in premature infants, in children with poor or compromised immune systems, or in children with deep organ or systematic infections, eradication of the infections may be more difficult to achieve. Mortality in low birth-weight premature infants with systemic candidiasis may reach 50 percent.

Prevention

Often candidiasis can be prevented through good sanitation procedures, such as keeping the body cool and dry, wearing natural fabric underclothes, changing underclothes frequently, wiping from front to back after bowel movements, and washing hands often. For children who are susceptible to candidiasis because of immune deficiencies, the regular use of antifungal drugs to prevent infections may be required.

Parental Concerns

Parents need to practice good hygienic procedures as they care for their children, in order to prevent the development of candidiasis.

Resources

Books

Martin, Jeanne Marie, and Rona P. Soltan. Complete Candida Yeast Guidebook: Everything You Need to Know about Prevention, Treatment, and Diet. New York: Prima Lifestyles, 2000.

The Official Patient's Sourcebook on Invasive Candidiasis. San Diego, CA: Icon Health Publications, 2002.

Web Sites

Greenberg, Michael E. "Candidiasis." eMedicine, September 1, 2004. Available online at www.emedicine.com/ped/topic312.htm (accessed December 7, 2004).

[Article by: Judith Sims Richard H. Lampert]

Candidiasis (thrush, monilia infection) is caused by a fungus that most commonly infects the mouth (usually of infants or persons with weakened immune systems), or the vagina (yeast infection). Another form of candidiasis causes painful inflammation under the fingernails (paronychia). It also occurs as an opportunistic infection in the late stages of HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome), as a nosocomial infection after catheterization; and it can invade the spinal canal and meninges, where it is obviously much more serious.

Candidiasis is transmitted by close contact of an infected with an uninfected mucous membrane. Infants acquire it as they pass through the birth canal. Topical application of antifungal paint or ointment can usually eliminate the infection and thus prevent transmission. Management is more difficult in debilitated and immunocompromised patients, in whom the condition can be very stubborn.

(SEE ALSO: Fungal Infections; Fungicides)

— JOHN M. LAST

An infection by Candida albicans.See also moniliasis; thrush.

Chronic hyperplastic candidiasis. (Ibsen/Phelan, 2000)

• Diseases and Infestations - candidiasis: yeastlike fungus infection in mouth and moist areas of body; thrush

"Thrush (infection)" redirects here. For the hoof infection, see Thrush (horse).

Candidiasis
Classification and external resources
Agar plate culture of Candida albicans
ICD-10	B37
ICD-9	112
DiseasesDB	1929
MedlinePlus	001511
eMedicine	med/264 emerg/76 ped/312 derm/67
MeSH	D002177

Candidiasis or thrush is a fungal infection (mycosis) of any of the Candida species (all yeasts), of which Candida albicans is the most common.^[1][2] Also commonly referred to as a yeast infection, candidiasis is also technically known as candidosis, moniliasis, and oidiomycosis.^[3]:308

Candidiasis encompasses infections that range from superficial, such as oral thrush and vaginitis, to systemic and potentially life-threatening diseases. Candida infections of the latter category are also referred to as candidemia and are usually confined to severely immunocompromised persons, such as cancer, transplant, and AIDS patients as well as non-trauma emergency surgery patients.^[4]

Superficial infections of skin and mucosal membranes by Candida causing local inflammation and discomfort are common in many human populations.^[2][5][6] While clearly attributable to the presence of the opportunistic pathogens of the genus Candida, candidiasis describes a number of different disease syndromes that often differ in their causes and outcomes.^[2][5]

Contents 1 Classification 2 Signs and symptoms 3 Causes 4 Diagnosis 5 Treatment 6 History 7 Society and culture 8 References 9 External links

Classification

Candidiasis may be divided into the following types:^{[3]:308–311}

• Oral candidiasis (Thrush)
• Perlèche (Angular cheilitis)
• Candidal vulvovaginitis (vaginal yeast infection)
• Candidal intertrigo
• Diaper candidiasis
• Congenital cutaneous candidiasis
• Perianal candidiasis
• Candidal paronychia
• Erosio interdigitalis blastomycetica
• Chronic mucocutaneous candidiasis
• Systemic candidiasis
• Candidid
• Antibiotic candidiasis (Iatrogenic candidiasis)

Signs and symptoms

Oral candidiasis.

Skin candidiasis.

Most candidial infections are treatable and result in minimal complications such as redness, itching and discomfort, though complication may be severe or fatal if left untreated in certain populations. In immunocompetent persons, candidiasis is usually a very localized infection of the skin or mucosal membranes, including the oral cavity (thrush), the pharynx or esophagus, the gastrointestinal tract, the urinary bladder, or the genitalia (vagina, penis).^[1]

Candidiasis is a very common cause of vaginal irritation, or vaginitis, and can also occur on the male genitals. In immunocompromised patients, Candida infections can affect the esophagus with the potential of becoming systemic, causing a much more serious condition, a fungemia called candidemia.^[5][6]

Thrush is commonly seen in infants. It is not considered abnormal in infants unless it lasts longer than a couple of weeks.^[7]

Children, mostly between the ages of three and nine years of age, can be affected by chronic mouth yeast infections, normally seen around the mouth as white patches. However, this is not a common condition.^{[citation needed]}

Symptoms of candidiasis may vary depending on the area affected. Infection of the vagina or vulva may cause severe itching, burning, soreness, irritation, and a whitish or whitish-gray cottage cheese-like discharge, often with a curd-like appearance. These symptoms are also present in the more common bacterial vaginosis.^[8] In a 2002 study published in the Journal of Obstetrics and Gynecology, only 33 percent of women who were self-treating for a yeast infection actually had a yeast infection, while most had either bacterial vaginosis or a mixed-type infection.^[9] Symptoms of infection of the male genitalia include red patchy sores near the head of the penis or on the foreskin, severe itching, or a burning sensation. Candidiasis of the penis can also have a white discharge, although uncommon.^{[citation needed]}

Causes

See also: Candida albicans

Candida yeasts are commonly present in humans, and their growth is normally limited by the human immune system and by other microorganisms, such as bacteria occupying the same locations (niches) in the human body.^[10]

C. albicans was isolated from the vaginas of 19% of apparently healthy women, i.e., those that experienced few or no symptoms of infection. External use of detergents or douches or internal disturbances (hormonal or physiological) can perturb the normal vaginal flora, consisting of lactic acid bacteria, such as lactobacilli, and result in an overgrowth of Candida cells causing symptoms of infection, such as local inflammation.^[11] Pregnancy and the use of oral contraceptives have been reported as risk factors,^[12] while the roles of engaging in vaginal sex immediately and without cleansing after anal sex and using lubricants containing glycerin remain controversial.^{[citation needed]} Diabetes mellitus and the use of anti-bacterial antibiotics are also linked to an increased incidence of yeast infections.^[12] Diet high in simple carbohydrates has been found to affect rates of oral candidiases,^[13] and hormone replacement therapy and infertility treatments may also be predisposing factors.^[14] Wearing wet swimwear for long periods of time is also believed to be a risk factor.^[2]

A weakened or undeveloped immune system or metabolic illnesses such as diabetes are significant predisposing factors of candidiasis.^[15] Diseases or conditions linked to candidiasis include HIV/AIDS, mononucleosis, cancer treatments, steroids, stress, and nutrient deficiency. Almost 15% of people with weakened immune systems develop a systemic illness caused by Candida species.^[16] In extreme cases, these superficial infections of the skin or mucous membranes may enter into the bloodstream and cause systemic Candida infections.

In penile candidiasis, the causes include sexual intercourse with an infected individual, low immunity, antibiotics, and diabetes. Male genital yeast infection is less common, and incidence of infection is only a fraction of that in women; however, yeast infection on the penis from direct contact via sexual intercourse with an infected partner is not uncommon.^[17]

Candida species are frequently part of the human body's normal oral and intestinal flora. Treatment with antibiotics can lead to eliminating the yeast's natural competitors for resources, and increase the severity of the condition^{[citation needed]}. Higher prevalence of colonization of C. albicans was reported in young individuals with tongue piercing, in comparison to non-tongue-pierced matched individuals.^[18] In the western hemisphere approximately 75% of females are affected at some time in their life.

Diagnosis

Micrograph of esophageal candidiasis. Biopsy specimen; PAS stain.

Diagnosis of a yeast infection is done either via microscopic examination or culturing.

For identification by light microscopy, a scraping or swab of the affected area is placed on a microscope slide. A single drop of 10% potassium hydroxide (KOH) solution is then added to the specimen. The KOH dissolves the skin cells but leaves the Candida cells intact, permitting visualization of pseudohyphae and budding yeast cells typical of many Candida species.

For the culturing method, a sterile swab is rubbed on the infected skin surface. The swab is then streaked on a culture medium. The culture is incubated at 37 °C for several days, to allow development of yeast or bacterial colonies. The characteristics (such as morphology and colour) of the colonies may allow initial diagnosis of the organism that is causing disease symptoms. ^[19]

Treatment

In clinical settings, candidiasis is commonly treated with antimycotics—the antifungal drugs commonly used to treat candidiasis are topical clotrimazole, topical nystatin, fluconazole, and topical ketoconazole.

For example, a one-time dose of fluconazole (150-mg tablet taken orally) has been reported as being 90% effective in treating a vaginal yeast infection.^[20] This dose is only effective for vaginal yeast infections, and other types of yeast infections may require different dosing. In severe infections amphotericin B, caspofungin, or voriconazole may be used. Local treatment may include vaginal suppositories or medicated douches. Gentian violet can be used for breastfeeding thrush, but when used in large quantities it can cause mouth and throat ulcerations in nursing babies, and has been linked to mouth cancer in humans and to cancer in the digestive tract of other animals.^[21]

Chlorhexidine gluconate oral rinse is not recommended to treat candidiasis^[22] but is effective as prophylaxis;^[23] chlorine dioxide rinse was found to have similar in vitro effectiveness against candida.^[24]

C. albicans can develop resistance to antimycotic drugs.^[25] Recurring infections may be treatable with other anti-fungal drugs, but resistance to these alternative agents may also develop.

History

The genus Candida and species C. albicans were described by botanist Christine Marie Berkhout in her doctoral thesis at the University of Utrecht in 1923. Over the years, the classification of the genera and species has evolved. Obsolete names for this genus include Mycotorula and Torulopsis. The species has also been known in the past as Monilia albicans and Oidium albicans. The current classification is nomen conservandum, which means the name is authorized for use by the International Botanical Congress (IBC).^[26]

The genus Candida includes about 150 different species; however, only a few are known to cause human infections. C. albicans is the most significant pathogenic species. Other Candida species pathogenic in humans include C. tropicalis, C. glabrata, C. krusei, C. parapsilosis, C. dubliniensis, and C. lusitaniae.

Society and culture

Some alternative medicine proponents postulate a widespread occurrence of systemic candidiasis (or candida hypersensitivity syndrome, yeast allergy, or gastrointestinal candida overgrowth), a medically unrecognised condition.^[27] The view was most widely promoted in a book published by Dr. William Crook^[28] that hypothesized that a variety of common symptoms such as fatigue, PMS, sexual dysfunction, asthma, psoriasis, digestive and urinary problems, multiple sclerosis, and muscle pain could be caused by subclinical infections of Candida albicans.^[28] Crook suggested a variety of remedies to treat these symptoms, including dietary modification, prescription antifungals, and colonic irrigation. With the exception of the few dietary studies in the urinary tract infection section, conventional medicine has not used most of these alternatives, since there is limited scientific evidence to prove either their effectiveness or that subclinical systemic candidiasis is a viable diagnosis.^{[29][30][31][32]}

In 1990 alternative health vendor Nature's Way signed an FTC consent agreement not to misrepresent in advertising any self-diagnostic test concerning yeast conditions or to make any unsubstantiated representation concerning any food or supplement's ability to control yeast conditions, with a fine of $30,000 payable to the National Institutes of Health for research in genuine candidiasis.^[27]

References

1. ^ ^{a b} Walsh TJ, Dixon DM (1996). "Deep Mycoses". In Baron S et al. eds.. Baron's Medical Microbiology (4th ed.). Univ of Texas Medical Branch. ISBN 0-9631172-1-1. http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.4006. 
2. ^ ^{a b c d} MedlinePlus Encyclopedia Vaginal yeast infection
3. ^ ^{a b} James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. 
4. ^ Kourkoumpetis T, Manolakaki D, Velmahos G, et al. (2010). "Candida infection and colonization among non-trauma emergency surgery patients". Virulence 1 (5): 359–66. doi:10.4161/viru.1.5.12795. PMID 21178471. http://www.landesbioscience.com/journals/viru/abstract.php?id=12795. 
5. ^ ^{a b c} Fidel PL (2002). "Immunity to Candida". Oral Dis. 8: 69–75. doi:10.1034/j.1601-0825.2002.00015.x. PMID 12164664. 
6. ^ ^{a b} Pappas PG (2006). "Invasive candidiasis". Infect. Dis. Clin. North Am. 20 (3): 485–506. doi:10.1016/j.idc.2006.07.004. PMID 16984866. 
7. ^ "Thrush". 2011. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001650/. Retrieved 2011-04-08. 
8. ^ Terri Warren, RN (2010). "Is It a Yeast Infection?". http://women.webmd.com/features/is-it-yeast-infection. Retrieved 2011-02-23. 
9. ^ Ferris DG; Nyirjesy P; Sobel JD; Soper D; Pavletic A; Litaker MS (March 2002). "Over-the-counter antifungal drug misuse associated with patient-diagnosed vulvovaginal candidiasis". Obstetrics and Gynecology 99 (3): 419–425. doi:10.1016/S0029-7844(01)01759-8. PMID 11864668. 
10. ^ Mulley, A. G.; Goroll, A. H. (2006). Primary Care Medicine: office evaluation and management of the adult patient. Philadelphia: Wolters Kluwer Health. pp. 802–3. ISBN 0-7817-7456-X. http://books.google.com/?id=aWQhTbwoM9EC&pg=RA1-PA802&lpg=RA1-PA802. Retrieved 2008-11-23. 
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14. ^ Nwokolo N C, Boag F C (May 2000). "Chronic vaginal candidiasis. Management in the postmenopausal patient". Drugs Aging 16 (5): 335–9. PMID 10917071. 
15. ^ Odds FC (1987). "Candida infections: an overview". Crit. Rev. Microbiol. 15 (1): 1–5. doi:10.3109/10408418709104444. PMID 3319417. 
16. ^ Choo Z.W., Chakravarthi S., Wong S.F., Nagaraja H.S., Thanikachalam P.M., Mak J.W., Radhakrishnan A., Tay A. (2010). "A comparative histopathological study of systemic candidiasis in association with experimentally induced breast cancer". Oncology Letters 1 (1): 215–222. doi:10.3892/ol_00000039. ISSN 1792-1082. http://www.spandidos-publications.com/ol/1/1/215. 
17. ^ David LM, Walzman M, Rajamanoharan S (October 1997). "Genital colonisation and infection with candida in heterosexual and homosexual males". Genitourin Med 73 (5): 394–6. PMC 1195901. PMID 9534752. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1195901. 
18. ^ Zadik Yehuda, Burnstein Saar, Derazne Estella, Sandler Vadim, Ianculovici Clariel, Halperin Tamar (March 2010). "Colonization of Candida: prevalence among tongue-pierced and non-pierced immunocompetent adults". Oral Dis 16 (2): 172–5. doi:10.1111/j.1601-0825.2009.01618.x. PMID 19732353. 
19. ^ Srikumar Chakravarthi, Nagaraja HS (2010). "A comprehensive review of the occurrence and management of systemic candidiasis as an opportunistic infection". Microbiology Journal 1 (2): 1–5. ISSN 2153-0696. http://scialert.net/abstract/?doi=mj.0000.20270.20270. 
20. ^ Moosa MY, Sobel JD, Elhalis H, Du W, Akins RA (2004). "Fungicidal Activity of Fluconazole against Candida albicans in a Synthetic Vagina-Simulative Medium". Antimicrob. Agents Chemother. 48 (1): 161–7. doi:10.1128/AAC.48.1.161-167.2004. PMC 310176. PMID 14693534. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=310176. 
21. ^ Craigmill A (December 1991). "Gentian Violet Policy Withdrawn". Cooperative Extension University of California -- Environmental Toxicology Newsletter 11 (5). http://extoxnet.orst.edu/newsletters/n115_91.htm. 
22. ^ "Chlorhexidine Gluconate". Drugs.Com. http://www.drugs.com/mtm/chlorhexidine-gluconate.html. Retrieved Jan 8, 2011. 
23. ^ Ferretti GA, Ash RC, Brown AT, Parr MD, Romond EH, Lillich TT (September 1988). "Control of oral mucositis and candidiasis in marrow transplantation: a prospective, double-blind trial of chlorhexidine digluconate oral rinse". Bone Marrow Transplant. 3 (5): 483–93. PMID 3056555. 
24. ^ Uludamar A, Ozkan YK, Kadir T, Ceyhan I (2010). "In vivo efficacy of alkaline peroxide tablets and mouthwashes on Candida albicans in patients with denture stomatitis". J Appl Oral Sci 18 (3): 291–6. doi:10.1590/S1678-77572010000300017. PMID 20857010. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-77572010000300017&lng=en&nrm=iso&tlng=en. 
25. ^ Cowen LE, Nantel A, Whiteway MS (July 2002). "Population genomics of drug resistance in Candida albicans". Proc. Natl. Acad. Sci. U.S.A. 99 (14): 9284–9. doi:10.1073/pnas.102291099. PMC 123132. PMID 12089321. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=123132. 
26. ^ International Code of Botanical Nomenclature. Königstein. 2000. ISBN 3-904144-22-7. http://www.bgbm.org/iapt/nomenclature/code/SaintLouis/0000St.Luistitle.htm. Retrieved 2008-11-23. 
27. ^ ^{a b} candidiasis hypersensitivity, National Council Against Health Fraud
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32. ^ Blonz ER (December 1986). "Is there an epidemic of chronic candidiasis in our midst?" (PDF). JAMA 256 (22): 3138–9. doi:10.1001/jama.1986.03380220104032. PMID 3783850. http://jama.ama-assn.org/content/256/22/3138.full.pdf. 

External links

• Candidiasis at the Open Directory Project

v d e Diseases of the skin and appendages by morphology Growths Epidermal wart callus seborrheic keratosis acrochordon molluscum contagiosum actinic keratosis squamous cell carcinoma basal cell carcinoma merkel cell carcinoma nevus sebaceous trichoepithelioma Pigmented Freckles lentigo melasma nevus melanoma Dermal and subcutaneous epidermal inclusion cyst hemangioma dermatofibroma keloid lipoma neurofibroma xanthoma Kaposi's sarcoma infantile digital fibromatosis granular cell tumor leiomyoma lymphangioma circumscriptum myxoid cyst Rashes With epidermal involvement Eczematous contact dermatitis atopic dermatitis seborrheic dermatitis stasis dermatitis lichen simplex chronicus Darier's disease glucagonoma syndrome langerhans cell histiocytosis lichen sclerosus pemphigus foliaceus Wiskott-Aldrich syndrome Zinc deficiency Scaling psoriasis tinea (corporis cruris pedis manuum faciei) pityriasis rosea secondary syphillis mycosis fungoides systemic lupus erythematosus pityriasis rubra pilaris parapsoriasis ichthyosis Blistering herpes simplex herpes zoster varicella bullous impetigo acute contact dermatitis pemphigus vulgaris bullous pemphigoid dermatitis herpetiformis porphyria cutanea tarda epidermolysis bullosa simplex Papular scabies insect bite reactions lichen planus miliaria keratosis pilaris lichen spinulosus transient acantholytic dermatosis lichen nitidus pityriasis lichenoides et varioliformis acuta Pustular acne vulgaris acne rosacea folliculitis impetigo candidiasis gonococcemia dermatophyte coccidioidomycosis subcorneal pustular dermatosis Hypopigmented tinea versicolor vitiligo pityriasis alba postinflammatory hyperpigmentation tuberous sclerosis idiopathic guttate hypomelanosis leprosy hypopigmented mycosis fungoides Without epidermal involvement Red Blanchable Erythema Generalized drug eruptions viral exanthems toxic erythema systemic lupus erythematosus Localized cellulitis abscess boil erythema nodosum carcinoid syndrome fixed drug eruption Specialized urticaria erythema (multiforme migrans gyratum repens annulare centrifugum ab igne) Nonblanchable Purpura Macular thrombocytopenic purpura actinic purpura Papular disseminated intravascular coagulation vasculitis Indurated scleroderma/morphea granuloma annulare lichen sclerosis et atrophicus necrobiosis lipoidica Miscellaneous disorders Ulcers Hair telogen effluvium androgenic alopecia trichotillomania alopecia areata systemic lupus erythematosus tinea capitis loose anagen syndrome lichen planopilaris folliculitis decalvans acne keloidalis nuchae Nail onychomycosis psoriasis paronychia ingrown nail Mucous membrane aphthous stomatitis oral candidiasis lichen planus leukoplakia pemphigus vulgaris mucous membrane pemphigoid cicatricial pemphigoid herpesvirus coxsackievirus syphilis systemic histoplasmosis squamous cell carcinoma

v d e Infectious diseases · Mycoses and Mesomycetozoea (B35–B49, 110–118) Superficial and cutaneous (dermatomycosis): Tinea=skin; Piedra (exothrix/ endothrix)=hair Ascomycota Dermatophyte (Dermatophytosis) By location Tinea barbae/Tinea capitis (Kerion) · Tinea corporis (Ringworm, Dermatophytid) · Tinea cruris · Tinea manuum · Tinea pedis (Athlete's foot) · Tinea unguium/Onychomycosis (White superficial onychomycosis · Distal subungual onychomycosis · Proximal subungual onychomycosis) Tinea corporis gladiatorum · Tinea faciei · Tinea imbricata · Tinea incognito · Favus By organism Epidermophyton floccosum · Microsporum canis · Microsporum audouinii · Trichophyton interdigitale/mentagrophytes · Trichophyton tonsurans · Trichophyton schoenleini · Trichophyton rubrum Other Hortaea werneckii (Tinea nigra) · Piedraia hortae (Black piedra) Basidiomycota Malassezia furfur (Tinea versicolor, Pityrosporum folliculitis) · Trichosporon spp (White piedra) Subcutaneous, systemic, and opportunistic Ascomycota Dimorphic (yeast+mold) Onygenales Coccidioides immitis/Coccidioides posadasii (Coccidioidomycosis, Disseminated coccidioidomycosis, Primary cutaneous coccidioidomycosis. Primary pulmonary coccidioidomycosis) · Histoplasma capsulatum (Histoplasmosis, Primary cutaneous histoplasmosis, Primary pulmonary histoplasmosis, Progressive disseminated histoplasmosis) · Histoplasma duboisii (African histoplasmosis) · Lacazia loboi (Lobomycosis) · Paracoccidioides brasiliensis (Paracoccidioidomycosis) Other Blastomyces dermatitidis (Blastomycosis, North American blastomycosis, South American blastomycosis) · Sporothrix schenckii (Sporotrichosis) · Penicillium marneffei (Penicilliosis) Yeast-like Candida albicans (Candidiasis, Oral, Esophageal, Vulvovaginal, Chronic mucocutaneous, Antibiotic candidiasis, Candidal intertrigo, Candidal onychomycosis, Candidal paronychia, Candidid, Diaper candidiasis, Congenital cutaneous candidiasis, Perianal candidiasis, Systemic candidiasis, Erosio interdigitalis blastomycetica) · C. glabrata · C. tropicalis · C. lusitaniae · Pneumocystis jirovecii (Pneumocystosis, Pneumocystis pneumonia) Mold-like Aspergillus (Aspergillosis, Aspergilloma, Allergic bronchopulmonary aspergillosis, Primary cutaneous aspergillosis) · Exophiala jeanselmei (Eumycetoma) · Fonsecaea pedrosoi/Fonsecaea compacta/Phialophora verrucosa (Chromoblastomycosis) · Geotrichum candidum (Geotrichosis) · Pseudallescheria boydii (Allescheriasis) Basidiomycota Cryptococcus neoformans (Cryptococcosis), Trichosporon spp (Trichosporonosis) Zygomycota (Zygomycosis) Mucorales (Mucormycosis) Rhizopus oryzae · Mucor indicus · Absidia corymbifera · Syncephalastrum racemosum Entomophthorales (Entomophthoramycosis) Basidiobolus ranarum (Basidiobolomycosis) · Conidiobolus coronatus/Conidiobolus incongruus (Conidiobolomycosis) Microsporidia (Microsporidiosis) Enterocytozoon bieneusi/Encephalitozoon intestinalis Mesomycetozoea Rhinosporidium seeberi (Rhinosporidiosis) Ungrouped Alternariosis · Fungal folliculitis · Fusarium (Fusariosis) · Granuloma gluteale infantum · Hyalohyphomycosis · Otomycosis · Phaeohyphomycosis M: MYC fung, clas fung drug (fung)

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