Candidiasis for the most part is a benign local infection. It most commonly colonizes the skin, nails, mucous membranes, and genitals. When Candida becomes invasive or a Systemic Infection, it is important to look for the underlying disorder.

Who is susceptible to Systemic Yeast?

There is generally a cause and effect system. Something has occurred that has caused the colonies of Candida to effectively dominate the flora and then spread out to other organs.

People with Systemic Yeast Infections are often in hospital settings. Candida is frequently recovered from the hospital environment, including foods, countertops, air-conditioning vents, floors, respirators, and medical personnel.

Increasing amounts of critically ill people are being treated for chronic conditions in the hospital, making them susceptible to a yeast infection caused by Candida. High-risk areas for Candida infection include neonatal, pediatric, and adult ICUs, both medical and surgical.

Systemic Yeast Infection in many cases can be seen as a by-product of our medical advances and instrumentations. It is most common in large hospitals with specialized clinics where the latest and most updated interventions are used. These advances include the use of the strongest antibiotics, chronic use of catheters, chemotherapy drugs for cancer, radiation therapy for various conditions, and steroids. Candida has in fact, become the fourth most common cause of hospital acquired infections.

Causes of Systemic Yeast Infection

Candida is the culprit. It is a thin-walled organism (fungi) that reproduce by budding. There are many types (over 150) but only a few (15) are known to be problematic to us. These organisms do not require much to grow, and include Candida albicans, Candida glabrata, Candida tropicalis, Candida parapsilosis, and Candida krusei. Of all the Candida species, Candida albicans is the most common type found on our skin and lining our respiratory, gastrointestinal, and genitourinary tracts.

Throughout the world, Candida species have replaced Cryptococcus species as the most common fungal pathogens affecting immunocompromised hosts.

Some of the other Candida species have predilections for certain conditions or disease states: cancer (C. glabrata), leukemia and low neutrophils (C. tropicalis), neonates and catheters (C. parapsilosis), and recipients of stem cell transplants (C. krusei). The different species are identified through sophisticated assays and testing for patterns. These tests are usually done at the larger labs.

Candida can become systemic in three ways:

• A strong antibiotic disturbs or clears the other normal flora organisms on the skin or mucous membranes leaving Candida as the survivor.
  
• Instruments such as catheters or any trauma (surgery) to the body breaks the skin and introduces Candida.
  
• An ineffective immune system that does not stop the spread or multiplication of the yeasts.
  

Systemic Yeast Infections can affect just about any organ. To travel to the different organs, the yeast must travel through, or seed the blood. This is referred to as Candidemia (or Candida in the blood). This is a very serious disease. With Candidemia, any organ touched by blood, which is all of them, can become infected. With blood flow to the heart valves, infective Endocarditis can result.

Bone infection can occur as the Candida seeds the spine and vertebral discs. Even blindness can happen when candida infects the retina. Involvement of the heart valves, bones and eyes can occur relatively quickly. Candida Endocarditis usually occurs in patients with prosthetic heart valves or in IV drug abusers.

People who have low immune cells as a result of chemotherapy, AIDs , and other immunity disease can develop a chronic process. With the weakened state of the body, the yeast infection can travel and slowly seed and affect the lungs, liver, spleen, and kidneys.

Treating Systemic Yeast Infection

Treatment for Systemic Yeast Infection takes place in a hospital. It is a serious infection and the patient can easily decompensate or get worse. The treatment includes removing all unnecessary catheters and instrumentation from the patient. Antifungals are the drugs of choice. Intravenous (IV) Fluconazole is the first line of therapy for yeast infections that have become systemic. It works well for Genitourinary Candidiasis and infected heart valves.

Amphotericin B is a much studied antifungal also used to treat Candidemia. Its use is limited in cases of hypersensitivity.

A new class of agents, Echinocandins, have been FDA approved to treat systemic yeast infection. Trials so far report few resistances.