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Yeast infections

A yeast is a form of fungus; thus, the term “yeast” does not denote which organism is involved. Nevertheless, almost all of the time that someone refers to a “yeast infection”, they are talking about a candida species, most often candida albicans.

This yeast frequently infects the mouth, neck skin folds and diaper regions of infants and diaper wearing toddlers. Breastfeeding mothers may have nipple involvement if the infant has thrush (yeast infection of the mouth). In menstruating females, the vagina is frequently involved. Less common sites include moist skin folds, skin under casts, and the recumbent skin (part that is touching the bed) in bedridden individuals.

Factors that increase the chances of getting a yeast infection:

  • recent antibiotics
  • steroid therapy
  • diabetes mellitus
  • pregnancy
  • oral contraceptive use
  • obesity

In those whose immune systems have been weakened by specific illnesses or medications (such as cancer chemotherapy or long-term steroid use), yeast infections may become serious. Involvement of the bladder and esophagus (tube connecting the mouth and stomach), are common besides the more usual mouth and vagina. A yeast infection of the blood known as candidemia is extremely serious.

For external use, and for vaginitis, clotrimazole ( Gyne-Lotrimin+and others) is a commonly used antifungal therapy available over-the-counter in a cream or vaginal suppository. For oral use, a nystatin swish and swallow solution is available by prescription. Nystatin is preferred in infants both for topical, or oral use, and again, requires a prescription. Oral fluconazole has gained acceptance as an alternative to the above treatments. For vaginal yeast infections, oral fluconazole can be given as a one-time dose, and has been found to be very effective.

For serious infections which may affect those with weakened immune systems, the treatments vary by the affected site. Oral fluconazole, nystatin swish and swallow, or nystatin bladder washes, may suffice for some illnesses, whereas others may require intravenous amphotericin B.