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Candida: The Yeast Likely

By Dr. Ivan Harris-Janz, B.Sc., N.D.


Just Another Fungi:

Candida are a group of commensal fungal species that are common human disease causing microorganisms. They are progressively becoming the most important fungal pathogens affecting humans, causing both internal and external disease. They occupy the mucosal and skin layers of the body resulting in local and systemic illness. There are several types of candida infections categorized according to body location.

   

Types of Candidiasis:

  1. Oral Thrush: Thrush is an infection of the oral cavity by the causative agent C. albicans. It may affect the lips, the insides of the cheeks, the tongue surface and roof of the mouth. Underlying disease is an important factor contributing to candida infection such as when the immune system is suppressed due to cancer or AIDS. However, thrush may occur in people with healthy immune systems particularly in diabetics and those who use dentures. It presents as curd-like white patches inside the mouth that are typically pronounced on the tongue and roof of the mouth. These patches may bleed when scraped exposing a red and inflamed area. Furthermore, the corners of the mouth may also become red and cracked when the infection is localized around the lips.
  2. Esophagitis: Candidal esophagitis is typically an invasion of thrush into the esophagus. Individuals with esophageal candidiasis may present with difficulty swallowing or painful swallowing, substernal pain (behind the breast bone), gastroesophageal reflux, or nausea without substernal pain. It is commonly associated with cancer and AIDS resulting from the decreased function of the immune system.
  3. Cutaneous: A skin infection from candida will present as red rashes affecting moist and enclosed areas such as from diapers, gloved hands and around the groin, fingernails and skin folds. It causes red, moist, weepy skin lesions with peripheral pustules around the area of infection. In addition there may be burning and itching and a well defined, pronounced red appearance of the affected area.
  4. Vaginal: Vaginal candidiasis is a common female infection affecting approximately 75% of women in their lifetime. Risk factors include pregnancy, uncontrolled diabetes mellitus, broad-spectrum antimicrobial treatment, corticosteroid use, and HIV infection. Symptoms may include vaginal itching, burning discharge, thick white curd-like discharge, and painful intercourse. The birth control pill, antibiotics and frequent douching all contribute to candida growth and frequency of infection.
  5. Systemic Candidiasis: Systemic infections may result from the progression of a localized candida infection. It represents a serious and potentially life-threatening illness that usually requires immediate intervention. Progression of the infection may include internal organs, the spinal column and brain. Symptoms may include shock, decreased kidney output, fever, disseminated intravascular coagulation, and meningitis.

Candida Related Complex (CRC)?

A contentious issue in the medical community is candida related complex, also know as chronic candidiasis or candida hypersensitivity syndrome. There has been no consensus on whether it is a valid diagnostic syndrome, however a collective body of clinical information suggests that there is reason to acknowledge its presence. Unfortunately, there have been very few clinical studies examining this issue and most are speculative or unverifiable. What is known has been popularized by Dr. William Crook, M.D., based on his observations and classifications examining the role of candida in chronic illness, especially when associated with gastrointestinal symptoms. The clinical manifestations of CRC include:

  1. Vaginal Infection: recurrent candida infections of the vagina leading to symptoms of burning, itching and abnormal discharge.
  2. Gastrointestinal Symptoms: such as gas, bloating, diarrhea, abdominal pain, constipation, and heartburn.
  3. General Symptoms: fatigue, lethargy, headache, and irritability.
  4. Respiratory: rhinitis, sneezing and/or wheezing.
  5. Nervous System: numbness, burning, tingling, depression, anxiety, memory disturbances and decreased ability to concentrate.
  6. Menstrual: such as endometriosis, premenstrual tension, cramps and other menstrual irregularities.
  7. Skin: hives, athlete’s foot, fungal infections of the nails or groin, psoriasis and other chronic rashes.
CRC represents a cluster of symptoms and findings that possibly indicate an underlying candida infection. However, similar clinical manifestations may occur in other disease processes, therefore diagnosis of CRC may be difficult and exclusion of other diagnoses may be necessary.
 

Predisposing Factors:

There are several factors that contribute to candida growth even in relatively healthy individuals such as:

Diagnosis:

The basis of diagnosis includes presenting symptoms, physical exam findings and laboratory testing. In the case of skin related candida infections, a sample may be collected by scraping the skin and then applying a potassium hydroxide solution in order to identify hyphal and budding cells under microscopy. Vaginal and oral candidiasis determination is based on clinical findings such as white curd-like patches, but may also include scrapings and potassium hydroxide application examined under microscopy. Systemic dissemination, which may be fatal, requires rapid identification through blood testing, fluid cultures and microscopy. Candida related complex or candida sensitivity may be determined based upon IgG, IgM or IgA immunoglobulins, candida immune complexes, or stool culture and microscopy to determine the presence of candida.

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