Candidiasis is a disease caused by the fungus, Candida albicans. It normally can be found on the skin, in the stomach, colon, rectum, vagina, and in the mouth and throat. Most of the time, it is harmless and actually helps keeps bacteria under control. Sometimes, however, the fungus can multiply which can lead to various problems. 

There are several types of candidiasis. Vaginal candidiasis is commonly known as a yeast infection. Candidiasis in the mouth or thoat is known as thrush; if it’s in the esophagus, it’s called esophageal candidiasis.

Candidiasis is more likely to occur in people with weakened immune systems. Using antibiotics—especially over long periods of time—can also cause an infection to develop in the mouth or vagina. Oral thrush can occur in people who use inhaled steroids, such as those for treating asthma and other lung problems. Poor oral hygiene, smoking, and excessive alcohol and sugar consumption can also play a role in the development of thrush. 

  

What are the symptoms?

Symptoms depend on the part of the body that’s affected. If you have any of these symptoms, you should contact your doctor:

  • Oral candidiasis: Symptoms include burning pain in the mouth or throat, altered taste (especially when eating spicy or sweet foods), and difficulty swallowing. It appears as white or pinkish-red blotches on the tongue, gums, the sides or roof of the mouth, and the back of the throat. Sometimes, thrush can cause the corners of the mouth to become chapped, cracked, and sore.
  • Esophageal candidiasis: This type of candidiasis occurs deep down in the throat and can’t always be seen by looking into the mouth. It can cause chest pain, as well as pain and difficulty when swallowing. This is much more common in people with HIV with lower CD4 counts.
  • Vaginal candidiasis: The most obvious symptom is a thick white discharge resembling cottage cheese. It can also cause itching and burning in or around the vagina, as well as a rash and tenderness of the outer lips of the vagina (labia). Women living with HIV are more likely to experience recurrent vaginal candidiasis than women who are HIV negative.

How is candidiasis diagnosed?

Most of the time, a doctor can diagnose candidiasis simply by looking in the mouth, at the back of the throat, or in the vagina. Sometimes it is necessary to scrape the overgrowth so that a sample can be sent to a lab. Assessing symptoms, X-rays and a special flexible microscope called an endoscope are used to look for candidiasis in the throat. People with thrush should be checked for possible esophageal disease as well.

How is candidiasis treated?

Candidiasis in the mouth or throat is usually treated with antifungal medicine (clotrimazole, miconazole, or nystatin) applied to the inside of the mouth. For servere infections, the antifungal medication fluconazole is the most common treatement. Fluconazole is also used as treatement for esophageal candidiasis. 

The most common treatment for vaginal candidiasis is medicated creams or inserts placed into the vagina. Most are available over-the-counter in many drug stores. As with thrush, if vaginal yeast infections are severe, do not go away, or if the infection returns soon after treatment is stopped, other treatments may be required. 

How should pregnant women be treated for candidiasis?

Because many antifungal drugs can be toxic to a developing fetus, the CDC recommends that topical treatments—such as creams or suppositories for vaginal candidiasis—be used whenever possible.

 

Can candidiasis be prevented?

There is no guaranteed way to prevent infection with the fungus or to prevent developing oral thrush, vaginal yeast infections, or more serious forms of candidiasis. These infections are more likely to occur in people with CD4 counts below 200. Thus, one way to help prevent it from occurring is to keep the immune system healthy—by taking HIV medications, reducing stress, eating right and getting plenty of rest.

Here are some tips to help prevent candidiasis:

  • Watch your diet: It may be helpful to avoid foods high in sugar, dairy, yeast, wheat and caffeine. These are believed to promote fungal overgrowth.
  • Eat yogurt: Many experts also recommend eating lots of yogurt that contains Lactobacillus acidophilus, a “good” bacteria believed to keep Candida albicans under control. 
  • Practice good oral hygiene: This includes brushing regularly, flossing, using an antiseptic mouthwash (Listerine, etc.), and reducing/eliminating the use of tobacco products such as chewing tobacco and cigarettes.
  • Women should wear loose, natural-fiber clothing and undergarments with a cotton crotch: This helps reduce the risk of vaginal infections. Also, stay away from deodorant tampons and feminine deodorant sprays.

Last Reviewed: February 2, 2022