It is generally believed that yeast colonisation of the mouth or the gut is not by itself a disease. Under certain circumstances, however, the aggressive potential of the yeast increases and defined diseases occur. Intensive chemotherapy, immunosuppressive drugs, HIV infection and other diseases that cause immunosuppression, for example diabetes mellitus, and being overweight contribute to this problem.3
The causative agent C. albicans and other less pathogenic yeasts of the genus Candida are a heterogeneous collection of yeast species that do not produce ascospores or teliospores. The morphological feature of this group of yeasts (with the exception of C. glabrata) is the capacity to form pseudomycelia. C. albicans alone is suggested to be the causative agent in 85-90% of clinically manifest infections.4
Candida infections of the skin most often affect the intertriginous folds of the genitocrural, as well as the submammary and subaxillary areas. These "intertrigos" have a erythematous moist appearance, sometimes with removable white smear, and characteristically with single erythematous satellite vesicopustules at the periphery. Interdigital Candida infections occur on the feet and, especially in workers with high exposure to humidity, on the hands. Nails can also be infected. Candida is one major cause of diaper dermatitis in infants.
Oral clinically manifest Candida infections may occur as pseudomembranous, atrophic or hyperplastic candidosis. Black hairy tongue and the so-called perleche of the lateral lips are other typical oral manifestations.
Other conditions such as seborrhoeic eczema as well as general weakness and other ill-defined symptoms, the so-called Candida hypersensitivity syndrome, have been associated with gut colonisation by yeasts. However, formal proof of the relevance of any of these conditions to colonisation by Candida is lacking.5
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.