Candidiasis is a yeast infection caused by Candida albicans. In people with HIV, the virus that causes AIDS, candidiasis commonly affects the skin and mucous membranes such as the mouth, throat, esophagus and vagina. Although troublesome and sometimes painful, candidiasis is rarely life-threatening.
Candidiasis also can occur in healthy people, but it does not usually cause disease. It is kept in check by bacteria that colonize these areas, by white blood cells and by additional immune defenses. Even in people with healthy immune systems, however, candidiasis can occur under certain conditions. For example, antibiotic drugs can kill the bacteria that keep the yeast population in check, leading to vaginal or mouth infections.
Symptoms and Diagnosis
The signs and symptoms of oral candidiasis (in the mouth and throat) include white or red patches in the mouth, tongue or throat, cracking and soreness at the corners of the mouth, altered taste, mouth pain or burning; candidiasis in the esophagus can cause upper chest pain, sore throat and painful or difficult swallowing; in the vagina, candidiasis causes a white cheesy vaginal discharge accompanied by vaginal itching and burning.
Doctors diagnose candidiasis if a patient's symptoms suggest a yeast infection, and if they detect yeast in the scrapings taken from infected areas. To diagnose a Candida infection in the esophagus, doctors may need to take an x-ray or insert a tiny tube down the throat to see the area and take scrapings.
Doctors usually treat people with HIV-related candida infections with clotrimazole or nystatin. Patients take these drugs several times a day for about two weeks as lozenges or a swish-and-swallow preparation to treat candidiasis of the mouth or throat, or use them as vaginal creams or tablets for vaginal infections. If these topical therapies are not effective, or the patient has candidiasis of the esophagus, either oral fluconazole or ketoconazole tablets can be taken.
Doctors may prescribe amphotericin B if the yeast infection does not respond to the above treatments. Amphotericin B must be given through a vein. It works very well but can cause serious side effects.
Candidiasis recurs in many people with HIV infection. Clinical trials are ongoing to determine if it is beneficial to continue patients on the oral or topical medications in an effort to prevent recurrent infection.
The National Institute of Allergy and Infectious Diseases (NIAID) funds research aimed at finding new drugs for the treatment or prevention of candidiasis. For more information on these or other studies, call the AIDS Clinical Trials Information Service:
1-800-TRIALS-A 1-800-243-7012 (TDD/Deaf Access)
For federally approved treatment guidelines on HIV/AIDS, call the HIV/AIDS Treatment Information Service:
1-800-HIV-0440 1-800-243-7012 (TDD/Deaf Access)
NIAID, a component of the National Institutes of Health, supports research on AIDS, tuberculosis and other infectious diseases as well as allergies and immunology. NIH is an agency of the U.S. Public Health Service, U.S. Department of Health and Human Services.
Prepared by: Office of Communications National Institute of Allergy and Infectious Diseases National Institutes of Health Bethesda, MD 20892
Public Health Service U.S. Department of Health and Human Services April 1995