In vaginal yeast infection in pregnancy, treatment with topical azole antifungals is recommended for seven days instead of a shorter duration.For vaginal yeast infections, many complementary treatments are proposed, however a number have side effects. No benefit from probiotics has been found for active infections. Blood infection
Treatment typically consists of oral or intravenous antifungal medications. In candidal infections of the blood, intravenous fluconazole or an echinocandin such as caspofungin may be used. Amphotericin B is another option. Prognosis
Among individuals being treated in intensive care units, the mortality rate is about 30–50% when systemic candidiasis develops. Epidemiology
Oral candidiasis is the most common fungal infection of the mouth, and it also represents the most common opportunistic oral infection in humans. Infections of the mouth occur in about 6% of babies less than a month old. About 20% of those receiving chemotherapy for cancer and 20% of those with AIDS also develop the disease.It is estimated that 20% of women may be asymptomatically colonized by vaginal yeast. In the United States there are approximately 1.4 million doctor office visits every year for candidiasis. About three-quarters of women have at least one yeast infection at some time during their lives.Esophageal candidiasis is the most common esophageal infection in persons with AIDS and accounts for about 50% of all esophageal infections, often coexisting with other esophageal diseases. About two-thirds of people with AIDS and esophageal candidiasis also have oral candidiasis.Candidal sepsis is rare. Candida is the fourth most common cause of bloodstream infections among hospital patients in the United States.
A rough diagnosis may also be made through revealing of clinical symptoms, including enlarged head size, along with radiological studies, and negative tests for other leukodystrophies. Treatment
No cure or standard procedure for treatment is known, although a University of Wisconsin study shows promise with gene editing of the astrocytes. A phase III clinical trial of an antisense therapy, sponsored by Ionis Pharmaceuticals, began in 2021. A bone marrow transplant has been attempted on a child, but it made no improvement. Hydrocephalus may be seen in younger patients and can be relieved with surgery or by implanting a shunt to relieve pressure. Prognosis
The prognosis is generally poor. With early onset, death usually occurs within 10 years from the onset of symptoms. Individuals with the infantile form usually die before the age of seven. Usually, the later the disease occurs, the slower its course. Prevalence
Its occurrence is very rare. The infantile form occurs from birth to 2 years of age. The average duration of the infantile form is usually about 3 years. Onset of the juvenile form presents between 2 and 12 years of age. Duration of this form is in most cases about 6 years. The adult form occurs after 12 years. In younger patients, seizures, megalencephaly, developmental delay, and spasticity are usually present. Neonatal onset is also reported. Onset in adults is least frequent. In older patients, bulbar or pseudobulbar symptoms and spasticity predominate. Symptoms of the adult form may also resemble multiple sclerosis. No more than 500 cases have been reported.