Fungal Infections

February 25, 2012

Invasive fungal disease in PICU: epidemiology and risk factors.

Invasive fungal disease in PICU: epidemiology and risk factors.

Feb 2012

Brissaud OGuichoux JHarambat JTandonnet OZaoutis T.


 Candida and Aspergillus spp. are the most common agents responsible for invasive fungal infections in children. They are associated with a high mortality and morbidity rate as well as high health care costs. An important increase in their incidence has been observed over the past two decades. In infants and children, invasive candidiasis is five times more frequent than invasive aspergillosis. Candida sp. represents the third most common agent found in healthcare-associated bloodstream infections in children. Invasive aspergillosis is more often associated with haematological malignancies and solid tumours. Recommendations concerning prophylactic treatment for invasive aspergillosis have been recently published by the Infectious Diseases Society of America. Candida albicans is the main Candida sp. associated with invasive candidiasis in children, even if a strong trend towards the emergence of Candida non-albicans has been observed. The epidemiology and the risk factors for invasive fungal infections are quite different if considering previously healthy children hospitalized in the pediatric intensive care unit, or children with a malignancy or a severe haematological disease (leukemia). In children, the mortality rate for invasive asp

Annals of Intensive Care



October 29, 2008

Candida Infections

Filed under: fungal infections — Tags: , , , , , , — patoconnor @ 1:30 pm

Candida Infections

What Is It?

Candidiasis is an infection caused by Candida fungi, especially Candida albicans. These fungi are found almost everywhere in the environment. Some may live harmlessly along with the abundant “native” species of bacteria that normally colonize the mouth, gastrointestinal tract and vagina. Usually, Candida is kept under control by the native bacteria and by the body’s immune defenses. If the native bacteria are decreased by antibiotics or if the person’s immune system is weakened by illness (especially AIDS or diabetes), malnutrition, or certain medications (corticosteroids or anticancer drugs),

Candida fungi can multiply to cause symptoms.  Candida infections can cause occasional symptoms in healthy people.

Candidiasis can affect many parts of the body, causing localized infections or larger illness, depending on the person and his or her general health.

Types of candidiasis include:

  • Thrush — Thrush is the common name for a mouth infection caused by the Candida albicans fungus. It affects moist surfaces around the lips, inside the cheeks, and on the tongue and palate. Thrush is common in people with diseases such as cancer and AIDS, which both suppress the immune system. Thrush can develop in people with normal immune systems, too, particularly in people with diabetes or long-lasting irritation from dentures.

  • Esophagitis Candida infections of the mouth can spread to the esophagus, causing esophagitis. This infection is most common in people with AIDS and people receiving chemotherapy for cancer.

  • Cutaneous (skin) candidiasisCandida can cause skin infections, including diaper rash, in areas of skin that receive little ventilation and are unusually moist. Some common sites include the diaper area; the hands of people who routinely wear rubber gloves; the rim of skin at the base of the fingernail, especially for hands that are exposed to moisture; areas around the groin and in the crease of the buttocks; and the skin folds under large breasts.

  • Vaginal yeast infections — Vaginal yeast infections are not usually transmitted sexually. During a lifetime, 75% of all women are likely to have at least one vaginal Candida infection, and up to 45% have 2 or more. Women may be more susceptible to vaginal yeast infections if they are pregnant or have diabetes. The use of antibiotics or birth control pills can promote yeast infections. So can frequent douching.Deep candidiasis (for example, candida sepsis) — In deep candidiasis, Candida fungi contaminate the bloodstream and spread throughout the body, causing severe infection. This is especially common in newborns with very low birth weights and in people with severely weakened immune systems or severe medical problems. In these people, Candida fungi may get into the bloodstream through skin catheters, tracheostomy sites, ventilation tubing, or surgical wounds. Deep candidiasis also can occur in healthy people if Candida fungi enter the blood through intravenous drug abuse, severe burns or wounds caused by trauma.


    Candidiasis causes different symptoms, depending on the site of infection.

  • Thrush — Thrush causes curdlike white patches inside the mouth, especially on the tongue and palate and around the lips. If you try to scrape off this whitish surface, you will usually find a red, inflamed area, which may bleed slightly. There may be cracked, red, moist areas of skin at the corners of the mouth. Sometimes thrush patches are painful, but often they are not.
  • EsophagitisCandida esophagitis may make swallowing difficult or painful, and it may cause chest pain behind the breastbone (sternum).
  • Cutaneous candidiasis — Cutaneous candidiasis causes patches of red, moist, weepy skin, sometimes with small pustules nearby.
  • Vaginal yeast infections — Vaginal yeast infections may cause the following symptoms: vaginal itch and/or soreness; a thick vaginal discharge with a texture like soft or cottage cheese; a burning discomfort around the vaginal opening, especially if urine touches the area; and pain or discomfort during sexual intercourse.
  • Deep candidiasis — When Candida spreads to the bloodstream, it may cause a wide range of symptoms, from unexplained fever to shock and multiple organ failure. Diagnosis

    Your doctor will ask about your medical history, including diabetes, cancer, HIV, and other chronic illnesses. He or she also will ask about your diet and about your recent use of antibiotics or medications that can suppress the immune system. If your doctor suspects cutaneous candidiasis, he or she may ask how you care for your skin and about conditions that expose your skin to excessive moisture, such as using rubber gloves.

    Often, your doctor can diagnose thrush, cutaneous candidiasis, or vaginal yeast infection by a simple physical examination. However, if the diagnosis is uncertain, your doctor may scrape the surface to obtain cells to examine under a microscope or may culture a skin sample to identify fungus or yeast. A culture is especially helpful if you have a yeast infection that returns after treatment. In this case, the culture can help identify whether the yeast is resistant to usual antibiotic treatments. If your doctor suspects that you have an undiagnosed medical illness that increases your risk of candidiasis — such as diabetes, cancer or HIV — blood tests or other procedures may be necessary.

    To diagnose Candida esophagitis, your doctor will examine your esophagus with an endoscope, a flexible instrument that is inserted into your throat and allows your doctor look at the area directly. During this examination, called endoscopy, your doctor will take a sample of tissue (either a biopsy or a “brushing”) from your esophagus to be examined in a laboratory.

    To diagnose deep candidiasis, your doctor will draw a sample of blood to be checked in a laboratory for the growth of Candida fungi or other infectious agents.

    Expected Duration

    In otherwise healthy people who have thrush, cutaneous candidiasis, or vaginal yeast infections, Candida infections usually can be eliminated with a short treatment (sometimes a single dose) of antifungal dication. However, in people with AIDS or other diseases that weaken the immune system, Candida infections can be difficult to treat and can return after treatment. In people with weakened immune systems, candidiasis can be life threatening if it passes into the blood and spreads to vital organs.


    In general, you can prevent most Candida infections by keeping your skin clean and dry, by using antibiotics only as your doctor directs, and by following a healthy lifestyle, including proper nutrition. People with diabetes should try to keep their blood sugar under tight control.

    If you have HIV or another cause of recurrent episodes of thrush, antifungal drugs, such as clotrimazole (Lotrimin, Mycelex), can help to minimize flare-ups.


    Treatment of candidiasis varies, depending on the area affected:

  • Thrush — Doctors treat thrush with topical, antifungal medications such as nystatin (Mycostatin and others) and clotrimazole. For mild cases, a liquid version of nystatin can be swished in the mouth and swallowed, or a clotrimazole lozenge can be dissolved in the mouth. For more severe cases, ketoconazole (Nizoral) or fluconazole (Diflucan) can be taken once a day by mouth.
  • Esophagitis — Candida esophagitis is treated with ketoconazole, itraconazole (Sporanox) or fluconazole. (Fluconazole is the most effective medication for people with HIV/AIDS).
  • Cutaneous candidiasis — This skin infection can be effectively treated with a variety of antifungal powders and creams. The affected area must be kept clean and dry and protected from chafing.
  • Vaginal yeast infections — Vaginal yeast infections can be treated with antifungal medications that are applied directly into the vagina as tablets, creams, ointments or suppositories. These include butoconazole (Femstat), clotrimazole (Gyne-Lotrimin), miconazole (Monistat 3 and others), nystatin (Mycostatin and others), tioconazole (Trosyd) and terconazole (Vagistat-1). A single dose of oral fluconazole can be used, although this treatment is not recommended during pregnancy. Sex partners usually do not need to be treated.
  • Deep candidiasis — This infection is usually treated with intravenous amphotericin B (Abelcet) or fluconazole. When To Call A Professional

    Call your doctor whenever you have symptoms of candidiasis, especially if you have a chronic illness or a weakened immune system caused by cancer, HIV or medications that suppress the immune system.


    Typically, in otherwise healthy people with superficial candidiasis, a properly treated infection goes away without leaving permanent damage. Candidiasis is unlikely to return as long as the person remains healthy and well nourished. In people with chronic illnesses or weakened immune systems, episodes of candidiasis may be more resistant to treatment and may return after treatment ends. In people with deep candidiasis, those who are diagnosed quickly and treated effectively have the best prognosis, especially if their infection can be stopped before it spreads to major organs.

    Additional Info

    Centers for Disease Control and Prevention (CDC)
    1600 Clifton Road
    Atlanta, GA 30333
    Phone: 404-639-3534
    Toll-Free: 1-800-311-3435

    National Oral Health Information Clearinghouse
    1 NOHIC Way
    Bethesda, MD 20892-3500
    Phone: 301-402-7364
    Fax: 301-907-8830

    Last updated August 20, 2005



    Getting Rid of Yeast Infections

    by Judith Levine Willis

    It’s an itchy feeling you might hardly notice at first.

    Maybe, you muse, it’s just that your jeans are too tight.

    Actually, tight jeans may have something to do with it. But if the itch keeps getting itchier, even when your jeans have been off for awhile, then there’s something else involved.

    That something else could very well be a fungus whose technical name is Candida, and which causes what is often called a “yeast” infection. Such infections are most common in teenage girls and women aged 16to 35, although they can occur in girls as young as 10 or 11 and in older women (and less often, in men and boys as well). You do not have to be sexually active to get a yeast infection.

    The Food and Drug Administration now allows medicines that used to be prescription-only to be sold without a prescription to treat vaginal yeast infections that keep coming back. But before you run out and buy one, if you’ve never been treated for a yeast infection you should see a doctor. Your doctor may advise you to use one of the over-the-counter products or may prescribe a drug called Diflucan (fluconazole). FDA recently approved the drug, a tablet taken by mouth, for clearing up yeast infections with just one dose.

    Though itchiness is a main symptom of yeast infections, if you’ve never had one before, it’s hard to be sure just what’s causing your discomfort. After a doctor makes a diagnosis of vaginal yeast infection, if you should have one again, you can more easily recognize the symptoms that make it different from similar problems. If you have any doubts, though, you should contact your doctor.

    In addition to intense itching, another symptom of a vaginal yeast infection is a white curdy or thick discharge that is mostly odorless. Although some women have discharges midway between their menstrual periods, these are usually not yeast infections, especially if there’s no itching.

    Other symptoms of a vaginal yeast infection include:

    • soreness
    • rash on outer lips of the vagina
    • burning, especially during urination.

    It’s important to remember that not all girls and women experience all these symptoms, and if intense itching is not present it’s probably something else. Candida is a fungus often present in the human body. It only causes problems when there’s too much of it. Then infections can occur not only in the vagina but in other parts of the body as well–and in both sexes. Though there are four different types of Candida that can cause these infections, nearly 80 percent are caused by a variety called Candida albicans.

    Many Causes

    The biggest cause of Candida infections is lowered immunity. This can happen when you get run down from doing too much and not getting enough rest. Or it can happen as a result of illness.

    Though not usual, repeated yeast infections, especially if they don’t clear up with proper treatment, may sometimes be the first sign that a woman is infected with HIV, the virus that causes AIDS.

    FDA requires that over-the-counter (OTC) products to treat yeast infections carry the following warning:

    “If you experience vaginal yeast infections frequently (they recur within a two-month period) or if you have vaginal yeast infections that do not clear up easily with proper treatment, you should see your doctor promptly to determine the cause and receive proper medical care.”

    Repeated yeast infections can also be caused by other, less serious, illnesses or physical and mental stress. Other causes include:

    • use of antibiotics and some other medications, including birth control pills
    • significant change in the diet
    • poor nutrition
    • diabetes
    • pregnancy.

    Some women get mild yeast infections towards the end of their menstrual periods, possibly in response to the body’s hormonal changes. These mild infections sometimes go away without treatment as the menstrual cycle progresses. Pregnant women are also more prone to develop yeast infections. Sometimes hot, humid weather can make it easier for yeast infections to develop. And wearing layers of clothing in the winter that make you too warm indoors can also increase the likelihood of infection.

    “Candida infections are not usually thought of as sexually transmitted diseases,” says Renata Albrecht, M.D., of FDA’s division of anti-infective drug products. But, she adds, they can be transmitted during sex.

    The best way not to have to worry about getting yeast infections this way is not to have sex. But if you do have sex, using a condom will help prevent transmission of yeast infections, just as it helps prevent transmission of more commonly sexually transmitted diseases, including HIV infection, and helps prevent pregnancy. Teens should always use a latex condom if they have sex, even if they are also using other forms of birth control. (See “On the Teen Scene: Preventing STDs” in the June 1993 FDA Consumer.)

    If one partner has a yeast infection, the other partner should also be treated for it. A man is less likely than a woman to be aware of having a yeast infection because he may not have any symptoms. When symptoms do occur, they may include a moist, white, scaling rash on the penis, and itchiness or redness under the foreskin. As with females, lowered immunity, rather than sexual transmission, is the most frequent cause of genital yeast infections in males.

    OTC Products

    The OTC products for vaginal yeast infections have one of four active ingredients: butoconazole nitrate (Femstat 3), clotrimazole (Gyne-Lotrimin and others), miconazole (Monistat 7 and others), and tioconazole (Vagistat). These drugs are in the same anti-fungal family and work in similar ways to break down the cell wall of the Candida organism until it dissolves. FDA approved the switch of Femstat 3 from prescription to OTC status December 1996 and a similar switch for Vagistat in February 1997. The others have been available OTC for a few years.

    When you visit the doctor the first time you have a yeast infection, you can ask which product may be best for you and discuss the advantages of the different forms the products come in: vaginal suppositories (inserts) and creams with special applicators. Remember to read the warnings on the product’s labeling carefully and follow the directions.

    Symptoms usually improve within a few days, but it’s important to continue using the medication for the number of days directed, even if you no longer have symptoms.

    Contact your doctor if you have the following:

    • abdominal pain, fever, or a foul-smelling discharge
    • no improvement within three days
    • symptoms that recur within two months.

    OTC products are only for vaginal yeast infections. They should not be used by men or for yeast infections in other areas of the body, such as the mouth or under the fingernails. Candida infections in the mouth are often called “thrush.” Symptoms include creamy white patches that cover painful areas in the mouth, throat, or on the tongue. Because other infections cause similar symptoms, it’s important to go to a doctor for an accurate diagnosis.

    Wearing artificial fingernails increases the chance of getting yeast infections under the natural fingernails. Fungal infections start in the space between the artificial and natural nails, which become discolored. Treatment for these types of infections–as well as those that occur in other skin folds, such as underarms or between toes–require different products, most of which are available only with a doctor’s prescription.

    Knowing the causes and symptoms of yeast infections can help you take steps–such as giving those tight jeans a rest–to greatly reduce the chances of getting an infection.

    And, if sometimes prevention isn’t enough, help is easily at hand from your doctor and pharmacy.

    Judith Levine Willis is editor of FDA Consumer.


  • Fungal Infections in Children

    Filed under: fungal infections — Tags: , , , , , , — patoconnor @ 1:09 pm

    Fungal Infections in Children

    What do you think of when you hear the word fungus? Do you think of mushrooms? A mushroom is one type of fungus, but fungus also refers to a type of germ that lives on all of us.

    This germ is harmless most of the time, but sometimes it can cause a problem called a fungal infection (say: fung-gul in-fek-shun). It sounds gross, but don’t worry or feel embarrassed. A lot of people get fungal infections, but they’re usually easy to treat becuase a fungus rarely spreads below the skin. If you get one of these infections, before you know it, you’ll be saying bye-bye to fungi (say: fung-guy).

    What Is a Fungal Infection?
    Fungi, the word for more than one fungus, can be found on different parts of the body. Here are some common types of fungal infections:

    Tinea (say: tih-nee-uh) is a type of fungal infection of the hair, skin, or nails. When it’s on the skin, tinea usually begins as a small red area the size of a pea. As it grows, it spreads out in a circle or ring. Tinea is often called ringworm because it may look like tiny worms are under the skin (but of course, they’re not!). Because the fungi that cause tinea (ringworm) live on different parts of the body, they are named for the part of the body they infect. Scalp ringworm is found on the head, and body ringworm affects the arms, legs, or chest.

    Athlete’s foot is another type of fungal infection that usually appears between the toes but can also affect toenails and the bottom or sides of the feet.

    Jock itch is a fungal infection of the groin and upper thighs. You might think only men and boys get it, but girls and women can get it, too. 


    (say: kan-duh-duh) is a yeast, similar to a fungus. It most often affects the skin around the nails or the soft, moist areas around body openings. Diaper rash in babies is one type of candidal infection, as is thrush (white patches often found in the mouths of babies.) Older girls and women may develop another form of candidal infection in and around the vagina. This is called a yeast infection.

    Why Do Kids Get Fungal Infections?
    Lots of kids get fungal infections. Kids love to share and hang out together. Some of these infections are  contagious (say: kon-tay-jus), which means they easily spread from person to person. Close contact or sharing a comb or hairbrush with someone who has tinea can spread the fungus from one person to another. Because fungi need a warm, dark, and humid place to grow, public showers, pools, locker rooms, and even the warmth of shoes and socks can give fungi the perfect opportunity to strike. 

    Taking antibiotics can cause some kids to get a yeast infection. Antibiotics get rid of germs that make us sick, but they can also kill many of the harmless bacteria in our body. These harmless bacteria normally fight with the yeast for a place to live, but when antibiotics kill them, the yeast is free to grow.

    Sometimes, a fungus may infect kids if they have an immune system disorder (this means their bodies can’t fight certain types of infections). This is rare, but it does happen.

    How Do I Know If I Have a Fungal Infection?

    There aredoctor. Here are some signs you and a parent can look for:

    • Athlete’s foot causes symptoms that include red, dry, cracked, and itchy skin between the toes. Some people also have red, scaly bumps filled with pus on the bottoms and sides of their feet.
    • Jock itch appears as a rash with elevated edges. It’s itchy and often feels like it is burning. It’s pretty common, especially if you play sports. Sweating and wearing athletic equipment can bring on this kind of rash. 
    • Ringworm of the head begins as a small pimple or scaly patch that looks like dandruff. The pimple or patch becomes larger and the hair in the infected area can become brittle and break off. This can create scaly patches of baldness, but the hair will grow back. If you have ringworm on your arms, legs, or chest, you may see small, red spots that grow into large rings.
    • Candida, the yeast, causes the skin around the infected area to itch. The skin may also be red and swollen.

    Farewell to Fungus!
    Getting rid of a fungal infection is not that difficult. Your doctor may decide to scrape a small amount of the irritated skin or clip off a piece of hair or nail and look at it under a microscope. Once your doctor knows what kind of infection you have, there are special antifungal creams and shampoos that can help to get rid of it. Sometimes the doctor will prescribe a
    medicine to take. Make sure you take the medicine for as long as the doctor tells you.

    Maybe fungal infections can’t be avoided altogether, but there are some ways you can help yourself ward them off.

    Walk away from athlete’s foot by:

    • Washing your feet every day.
    • Drying your feet completely, especially between your toes.
    • Wearing sandals or shower shoes when walking around in locker rooms, public pools, and public showers.
    • Wearing clean socks. If they get wet or damp, be sure to change them as soon as you can.
    • Using a medicated powder on your feet to help reduce perspiration. (Ask a parent first.)

    You can ditch jock itch by: 

    • Wearing clean, cotton underwear and loose-fitting pants.
    • Keeping your groin area clean and dry.

    Prevent beastly yeast infections by:

    • Changing out of wet swimsuits instead of lounging around in them. 
    • Wearing clean, cotton underpants.

    There may always be a “fungus among us,” but we can make it a lot tougher for them to invade and grow!

    Reviewed by: Patrice Hyde, MD
    Date reviewed: May 2004

    Kids Health

    Types of Fungal Infections

    Related Terms:  Tinea, Athlete’s Feet, Candida, Jock Itch, Yeast Infections, Oral thrush, Cryptococcosis, Sporotrichosis, Pityriasis Versicolor, Histoplasmosis, Blastomycosis, Tinea Pedis, Tinea Cruris, Tinea Corporis, Tinea Unguiuum, Tinea Barbae, Tinea Manuum, Tinea Capitis

    Types of Fungal Infections

    For those of us with lymphedema, proper skin care is essential to our health and well being. The skin must be cared for correctly and every effort must be made to avoid fungus and fungal infections. If after all we do, we acquire one, it must be treated promptly. These fungal infections can be catastrophic.

    Definition of a fungus:  Member of a class of primitive vegetable organisms. These plants lack cholorphyll, are generally parasitic and reproduce by spores. 

    Fungus causing infections can be classified in two distinct groupings. Fungus infections from a mold-like fungi include athlete’s feet, jock itch, ringwowrm  and tinea capitis.

    Fungus infections from a yeast-like fungi include diaper rash, oral thrush, cutaneous candida and some genital rashes.

    Fungal Infections


    Skin Fungus Infections

    Types of Fungal infections

    Types list: The list of types of Fungal infections mentioned in various sources includes:

    Vaginal Candidiasis
    Oral thrush
    Athlete’s foot
    Yeast infections
    Ringworm – not a worm but a fungus.

    Pityriasis Versicolor

    Types discussion: Mycoses can affect your skin, nails, body hair, internal organs such as the lungs, and body systems such as the nervous system. Aspergillus fumigatus, for example, can cause aspergillosis, a fungal infection in the respiratory system.
    Some fungi have made our lives easier. Penicillin and other antibiotics, which kill harmful bacteria in our bodies, are made from fungi. Other fungi, like certain yeasts, also can be beneficial. For example, when a warm liquid like water and a food source are added to certain yeasts, the fungus ferments. The process of fermentation is essential for making healthy foods like some breads and cheeses.1

    Acknowledgment and Thanks


    Fungal infections

    diseases caused by organisms of the kingdom Fungi, which includes various genera that may cause disorders with musculoskeletal manifestations (Table 1). These pathogical conditions are discussed in more detail under their specific names.
    Fungal infections, Table 1. Various types of fungal infections.

    Disease Organism

    Actinomycosis Actinomyces species

    Nocardiosis Nocardia species
    Cryptococcosis (torulosis) Cryptococcus neoformans

    North American blastomycosis Blastomyces dermatitidis

    South American blastomycosis (paracoccidioidomycosis) Blastomyces brasiliensis

    Coccidioidomycosis Coccidioides immitis

    Histoplasmosis Histoplasma capsulatum

    Sporotrichosis Sporothrix schenkii

    Candidiasis Candida albicans

    Mucormycosis Mucor species

    Aspergillosis Aspergillus species

    Maduromycosis (mycetoma) Madurella,Nocardia, Streptomyces species

    What are the different types of fungal infection?

    When it comes to human body, the term fungus refers to a type of germ that lives on all of us. This germ harmless most of the time, can cause problems occasionally. This is called a fungal infection. Persistent fungal infections may be indicators of an imbalance in the body’s microflora (the small, usually bacterial, inhabitants of gut,skin surfaces and mucous membranes).

    What are the different types of fungal infection?


    is a type of fungal infection of the hair, skin, or nails. When it’s on the skin, tinea usually begins as a small red area the size of a pea. As it grows, it spreads out in a circle or ring. Tinea is often called “ringworm” because it may look like tiny worms are under the skin (but of course, they’re not!). Because the fungi that cause tinea (ringworm) live on different parts of the body, they are named for the part of the body they infect. Scalp ringworm is found on the head, and body ringworm affects arms, legs, or the chest.
    Athlete’s foot

    is another type of fungal infection that usually appears between the toes but can also affect the bottom or sides of the feet.
    Jock itch

    is a fungal infection of the groin and upper thighs. (This usually occurs only in boys and men.)

    is a yeast-like fungus. This fungus most often affects the skin around the nails or the soft, moist areas around body openings. Diaper rash in babies is a form of candidal infection, as is thrush, the white patches most often found in the mouths of kids and babies. Older girls and women may develop another form of candidal infection in the area in and around the vagina. This is called a yeast infection



    Welcome to Fungal Infections

    Complete guide to fungal infections, types, causes and treatments.  This is a replacement site for my previous blog Fungus Infections.  We will cover information on the types of fungal infections, treatments and prevention.  Also, included will be abstracts and studies for further research.

    Blog at