Algae

Amnesic shellfish poisoning. Amnesic shellfish poisoning (ASP) is an illness caused

by consumption of the marine biotoxin called domoic acid. In mammals, including humans,
domoic acid acts as a neurotoxin, causing permanent short-term memory loss, brain damage,
and death in severe cases.

What are the symptoms of Amnesic Shellfish Poisoning?

Symptoms include vomiting, nausea, diarrhea, and abdominal cramps within 24 hours
of ingestion. In more severe cases, neurological symptoms develop within 48 hours and
include headache, dizziness, confusion, disorientation, short-term memory loss, motor
weakness, seizures, profuse respiratory secretions, cardiac arrhythmias, coma, and
possible death. Short term memory loss can be permanent.

Diagnosis:

The mouse assay used for ASP testing is the same as for PSP. The relative potency of
ASP toxins appear to be less than PSP. In addition, involuntary scratching of
shoulders with hind legs by the mice was noted and is not typical of PSP. HPLC
analysis can quantify domoic acid from contaminated shellfish in ASP episodes.

Management and Treatment:

At this point, the treatment of ASP is symptomatic and supportive. Teitelbaum et al

(1990) noted that the seizures respond to iv diazepam and phenobarbital. Three
patients were resistent to dilantin for seizure control.

As with many of the marine toxin induced diseases, the initial or index case(s) are
often the tip of the iceberg. Therefore any suspected cases of ASP should be reported
to the appropriate public health authorities for follow up to ascertain other cases and
to prevent further spread. And every effort should be made to obtain contaminated
materials and their source.

Since an estimated concentration of 200 ug/g wet weight domoic acid appeared to
affect some consumers, with a safety factor of 0.1 applied, Canada has set a
concentration of domoic acid of 20 ug/g wet weight above which shellfish commercial
operations should be closed. Finally, this epidemic has lead to new attention to the
diatoms, especially the appearance of the mucilage from diatoms with species of
Nitzschia. There is no antidote. In severe cases, oral rehydration is recommended.
Prevention of Amnesic Shellfish Poisoning

 Check with local health officials before collecting shellfish.

 Do not eat shellfish sold as bait. Bait products do not need to meet the same food safety
regulations as seafood for human consumption.
Ciguatera Fish Poisoning (Toxin) Definition

 Ciguatera is a foodborn illness (food poisoning) caused by eating fish

that is contaminated by ciguatera toxin. Ciguatera toxin is a heat-
stable lipid soluble compound, produced by dinoflagellates and
concentrated in fish organs, that can cause nausea, pain, cardiac, and
neurological symptoms in humans when ingested.

Ciguatera Fish Poisoning (Toxin) Symptoms

Eating ciguatera toxin contaminated fish result in the following symptoms:

 Symptoms generally begin 6 to 8 hours after eating the contaminated

fish but can occur as early as 2 or as late as 24 hours after ingestion.
 Symptoms include nausea, vomiting, diarrhea, muscle pain, numbness,
tingling, abdominal pain, dizziness, and vertigo. The classic finding of
hot and coldsensation reversal is actually a burning sensation on
contact with cold (allodynia).
 Teeth may feel loose and itching may be intense.
 Severe cases of ciguatera poisoning may result in shortness of breath,
salivation, tearing, chills, rashes, itching, and paralysis.
Bradycardia, coma and hypotensioncan occur. Death due to poisoning
is rare (less then 0.5 %).

Ciguatera Fish Poisoning (Toxin) Treatment

There is no specific antitoxin available for ciguatera toxin.
  Some investigators have suggested vomiting should be induced if the
victim is awake and alert and has eaten ciguatera toxin-containing fish
within the last 3 to 4 hours. Ipecac, a substance that causes vomiting,
was suggested as the medication to use, but many investigators now
think ipecac causes too much dehydration. Currently some physicians
recommend gastrointestinal decontamination with activated
charcoal. Activated charcoal may absorb the toxin if done 3 to 4 hours
after ingestion.
 Maintain hydration. Intravenous fluids may be necessary for
uncontrollable nausea and vomiting.
 No specific antidote is available.
 Osmotic diuretics have been used to decrease symptoms (for
example, mannitol[Osmitrol]).
 Amitriptyline (Elavil, Endep) and gabapentin (Neurontin, Gralise,
Horizant) may help reduce neural pain symptoms
 Diphenhydramine (Benadryl) and hydroxyzine (Atarax, Vistaril) may
help relieve itching.
 NSAID's and acetaminophen (Tylenol and others) may reduce pain
 Avoid alcohol, fish, nuts, and nut oils after exposure to ciguatera toxin
because they may trigger recurrent symptoms.

Nursing intervention
 Severe cases require hospitalization for intravenous fluids.
  Immediate medical attention is necessary for all cases because the
symptoms may rapidly progress in a few patients.
 A doctor should be consulted about treatment with available
medications. If necessary a doctor specializing in poisonings
(toxicologist) can be consulted.

Ciguatera Toxin Detection

Although some tests report the ability to detect this toxin in food, there are no
officially sanctioned tests for ciguatera toxin available. Research is ongoing;
investigators are researching the possibility of using monoclonal antibodies to
both detect the toxin and to use the antibodies to treat patients.

3. Prevention

3.1. Avoiding Ciguateric Fish

3.2. Surveillance and Reporting

3.3. Education and Outreach

Neurotoxic shellfish poisoning

Causes

● brevetoxins
Symptoms
● slurred speech, nausea, vomiting
Prevention:
Monitoring of dinoflagellate cell counts; avoid toxic shellfish; no antitoxin available

Treatment:
Supportive care

Fluid replacement

Observation of respiratory functions

Administration of sedatives

Pain mitigation
Diarrhetic shellfish poisoning

Causes:

Dinophysis spp

Symptoms:

Nausea, vomiting, diarrhea, abdominal poisoning

Prevention:

No antitoxin; avoid toxic shellfish

Treatment

Supportive care; may require ventilator support (PSP) or extended rehabilitation (DASP)

electrolyte replacement
protothecosis is a rare infection caused by members of the genus Prototheca.
Diagnosis
Detection of characteristic structures observed on histopathologic examination of tissue
Treatment
1. Antifungals
► Ketoconazole
► Itraconazole
► Fluconazole
► Conventional amphotericin B
► Liposomal amphotericin B
2. Surgical excision

DIAGNOSIS

 Isolation
 Clinical Laboratory Findings
 Cytologic Examination
 Molecular Techniques
Prevention:

Improving management
conditions, such as not using
muddy lodging areas


What is Paralytic Shellfish Poisoning?

Causes:
saxitoxin, neosaxiton and gonyautoxins I to IV

What are the symptoms?

 Tingling
 numbness around the mouth which can spread to the face, neck, arms and legs.
 nausea and vomiting
 weakness
 blurred vision
 change in temperature sensation
 loss of balance
 difficulty speaking or swallowing
 in severe cases difficulty breathing, paralysis and death can occur.

How is it diagnosed?

 clinical symptoms
 urine test

How is it treated?

 supportive care
 breathing support

How is it prevented?

3. should not eat uncooked shellfish (for example, "raw" oysters) to

prevent exposure to bacterial and viral diseases, cooking does not
destroy the poisons in contaminated shellfish. There are no
antidotes for these shellfish poisons.

Nursing intervention

4. Do not eat any shellfish that may be contaminated.

5. If possible keep samples of the shellfish that may be tested later for toxins.
6. If you think you have PSP seek urgent medical attention.
Fungi
The Candida albicans (C. albicans) fungus causes oral thrush. A
small amount of this fungus normally lives in your mouth without causing
harm. However, when the fungus begins to grow uncontrollably, an infection
can develop in your mouth.

How is oral thrush diagnosed?

Your doctor will probably be able to diagnose oral thrush simply by examining your
mouth and tongue for the characteristic white bumps.

In some cases, your doctor may take a biopsy to confirm the diagnosis. A biopsy
involves scraping off a very small portion of a bump in the mouth. The sample is then
sent to a laboratory, where it’ll be tested for the presence of C. albicans.

If oral thrush is in your esophagus, your doctor likely will perform more procedures to
ensure an accurate diagnosis. These can include a throat swab culture and
an endoscopy.

During a throat swab culture, your doctor will use a cotton swab to take a tissue
sample from the back of your throat. The sample will then be sent to a laboratory for
analysis.

Endoscopy involves the use of a thin tube with an attached light and camera. This is
called an endoscope. Your doctor will insert the endoscope through your mouth and
into your esophagus to examine the affected area. They may also remove a sample of
tissue for inspection.
How is oral thrush treated?
Treatment for oral thrush varies depending on your age and overall health. The
purpose of treatment is to prevent the growth and spread of the fungus.

Once treatment begins, oral thrush usually goes away within a couple of weeks.
However, oral thrush may return again in the future. A complete cure is more likely if
you have a healthy immune system and are free of other diseases.

If you have recurring cases of oral thrush and are otherwise healthy, your doctor will
evaluate you for an underlying condition that’s causing the thrush.

Medical treatments

The following medical treatments may be used for oral thrush.

 Fluconazole (Diflucan). Fluconazole is an oral antifungal medication.

 Clotrimazole (Mycelex Troche). Your doctor will prescribe the lozenge form of this
antifungal medication. The medication is left in the mouth until it dissolves.
 Nystatin (Nystop, Nyata). This is an antifungal mouthwash that you swish around
in your mouth and then swallow. In an infant, it’s swabbed in the mouth.
 Itraconazole (Sporanox). This oral antifungal is used for people who are resistant
to initial treatments or who have HIV.
 Amphotericin B (AmBisome, Fungizone). This drug is used to treat severe cases.

Home remedies

To treat oral thrush at home, be sure to:

 Brush your teeth with a soft toothbrush to avoid scraping the lesions. Replace the
toothbrush at the end of treatment.
 Properly clean your dentures.
 Don’t use mouthwashes or mouth sprays aside from prescribed ones.
 Maintain appropriate blood sugar levels if you have diabetes.

You can also try the following:

 Use a saltwater mixture to rinse your mouth. To make a saltwater rinse, mix 1/4 to
1/2 teaspoon of salt in 8 ounces of warm water.
 Eat unsweetened yogurt to help restore and maintain healthy levels of good
bacteria.

Shop for unsweetened yogurt.

Treatments for mothers and breastfeeding infants

When a breastfeeding infant has oral thrush, both the mother and infant should be
treated to prevent a cycle of retransmission. Treatment in these cases may include the
following:

 Use an antifungal medication for the baby and an antifungal cream for the
mother’s breasts, such as terbinafine (Lamisil) or clotrimazole (Lotrimin). Wipe the
cream off the breast before feeding your baby to prevent it from getting in their
mouth.
 Rinse pacifiers, bottle nipples, and all pieces of a breast pump in a solution of half
water and half vinegar. Allow the items to air-dry. You can also wash these in hot
water in the dishwasher, and allow to dry in the sun.
 Use nursing pads to prevent the fungus from spreading to clothes.

Find clotrimazole cream, terbinafine cream, or nursing pads.

What are the potential complications of
oral thrush?
Oral thrush rarely causes complications in people with healthy immune systems.

People whose immune systems are weakened by certain diseases or medical

treatments are the most likely to experience complications. If you have a weak
immune system, the fungus may enter your bloodstream and spread throughout your
body. This can eventually cause problems in various body structures, including
the brain, heart, and liver.

Infants who develop oral thrush also may get a severe diaper rash.

How can oral thrush be prevented?

You can reduce your risk for oral thrush by following these simple routines:

 Practice good oral hygiene by brushing your teeth. Also floss daily. This is
especially important if you have diabetes or wear dentures.
 Rinse out your mouth after using a corticosteroid inhaler.
 Add yogurt to your diet whenever you take prescribed antibiotics.
 Promptly treat a vaginal yeast infection, especially if you’re pregnant.

What are the symptoms of oral thrush?

In its initial stages, oral thrush may not cause any symptoms. However, as time passes
and the fungus continues to grow, the following symptoms may develop:
 creamy white bumps on the tongue, inner cheeks, gums, or tonsils
 slight bleeding when the bumps are scraped
 pain at the site of the bumps
 angular cheilitis, or dry, cracked skin at the corners of the mouth
 difficulty swallowing
 a bad taste in the mouth

In infants, oral thrush may occasionally cause:

 difficulty feeding
 fussiness
 irritability

Babies with oral thrush can transmit it to their mothers during breastfeeding. Mothers
and their infants can get caught in a cycle of transmission. If you’re breastfeeding and
your breasts contract the fungus, you may experience:

 intense itching, sensitivity, or pain in the nipples

 flaking or shiny skin on the area surrounding the nipple
 severe pain during breastfeeding
 sharp, piercing pain in the breast

What causes oral thrush?

Oral thrush occurs when the C. albicans fungus begins to grow out of control.
Normally, the immune system uses “good” microorganisms to keep C. albicans and
other “bad” microorganisms under control. When this balance is disrupted, harmful
bacteria and fungi begin to multiply. This leads an infection to develop.
Oral thrush can occur when your immune system is weakened by certain medications
that reduce the number of good microorganisms that would naturally prevent
infection. Cancertreatments, including chemotherapy and radiation, can also damage
or kill healthy cells. This makes you more susceptible to oral thrush and other
infections.

Diseases that attack your immune system, such as leukemia and HIV, also increase
your risk for oral thrush.

Diabetes, another illness that affects your immune system, can contribute to oral
thrush as well. If you have uncontrolled diabetes, you may have a high level of sugar
in your saliva. One theory is that C. albicans can then use this extra sugar to fuel its
growth in your mouth.

In newborns, oral thrush can be contracted at birth, though this is uncommon.

The same fungus that causes oral thrush also causes yeast infections, so pregnant
women with a vaginal yeast infection can occasionally pass a yeast infection to their
baby during delivery. Learn more about yeast infections during pregnancy.

Who’s at risk for oral thrush?

Babies and toddlers have the highest risk of developing oral thrush. However, it can
also affect people who have a weakened immune system. You may have a weak
immune system and be more at risk for oral thrush if you:

 have diabetes, anemia, or HIV

 have an illness that causes dry mouth
 take antibiotics or corticosteroids
 use chemotherapy, radiation, or drugs to treat cancer
 wear dentures
 smoke cigarettes
 recently had an organ transplant, which increases the risk of fungal infection

How is oral thrush diagnosed?

Your doctor will probably be able to diagnose oral thrush simply by examining your
mouth and tongue for the characteristic white bumps.

In some cases, your doctor may take a biopsy to confirm the diagnosis. A biopsy
involves scraping off a very small portion of a bump in the mouth. The sample is then
sent to a laboratory, where it’ll be tested for the presence of C. albicans.

If oral thrush is in your esophagus, your doctor likely will perform more procedures to
ensure an accurate diagnosis. These can include a throat swab culture and
an endoscopy.

During a throat swab culture, your doctor will use a cotton swab to take a tissue
sample from the back of your throat. The sample will then be sent to a laboratory for
analysis.

Endoscopy involves the use of a thin tube with an attached light and camera. This is
called an endoscope. Your doctor will insert the endoscope through your mouth and
into your esophagus to examine the affected area. They may also remove a sample of
tissue for inspection.
Tinea Capitis

Causes
Fungi called dermatophytes cause ringworm of the scalp. Fungi are
organisms that thrive on dead tissue, such as fingernails, hair, and the outer
layers of your skin. Dermatophytes prefer warmth and moisture, so they thrive
on sweaty skin. Overcrowding and poor hygiene increase the spread of
ringworm.

Ringworm spreads easily, especially among children. You can get ringworm
from touching the skin of an infected person. If you use combs, bedding, or
other objects that have been used by an infected person, you’re also at risk.

House pets, such as cats and dogs, can spread ringworm, too. Farm animals
like goats, cows, horses, and pigs can also be carriers. However, these
animals might not show any signs of infection.

Symptoms
The most common symptom of ringworm is itchy patches on the scalp.
Sections of hair may break off near the scalp, leaving scaly, red areas or bald
spots. You may see black dots where the hair has broken off. Left untreated,
these areas can gradually grow and spread.

Other symptoms include:

 brittle hair
 painful scalp
 swollen lymph nodes
 low-grade fever

In more severe cases, you may develop crusty swellings called kerion that
drain pus. These can lead to permanent bald spots and scarring

How it’s diagnosed

A visual exam is often enough for a doctor to diagnose ringworm of the scalp.
Your doctor may use a special light called a Wood’s lamp to illuminate your
scalp and determine signs of infection.

Your doctor may also take a skin or hair sample to confirm the diagnosis. The
sample is then sent to a lab to determine the presence of fungi. This involves
looking at your hair or a scraping from a scaly patch of scalp under a
microscope. This process may take up to three weeks.

Treatment
Your doctor will probably prescribe fungi-killing oral medication and medicated
shampoo.

Antifungal medication

The leading antifungal medications for ringworm are griseofulvin (Grifulvin V,

Gris-PEG) and terbinafine hydrochloride (Lamisil). Both are oral medications
that you take for approximately six weeks. Both have common side effects,
including diarrhea and upset stomach. Your doctor may recommend taking
these medications with a high-fat food such as peanut butter or ice cream.

Other possible side effects of griseofulvin include:

 sun sensitivity
 vomiting
 fatigue
 faintness
 dizziness
 allergic reactions in people who are also allergic to penicillin
 headache
 rash
 hives

Other possible side effects of terbinafine hydrochloride include:

 stomach pain
 itching
 rash
 hives
 loss of taste or change in taste
 allergic reaction
 headache
 fever
 liver problems, in rare cases

Medicated shampoo

Your doctor may prescribe a medicated shampoo to remove fungus and

prevent the spread of infection. The shampoo contains the active antifungal
ingredient ketoconazole or selenium sulfide. Medicated shampoo helps
prevent the fungus from spreading, but it doesn’t kill ringworm. You must
combine this type of treatment with an oral medication.

Your doctor may tell you to use this shampoo a couple times per week for a
month. Leave the shampoo on for five minutes, then rinse.

Preventing ringworm of the scalp

The dermatophytes that cause ringworm are common and contagious. This
makes prevention difficult. Because children are especially susceptible, tell
your children about the risks of sharing hairbrushes and other personal items.
Regular shampooing, hand washing, and other normal hygiene routines can
help prevent the spread of infection. Be sure to teach your children proper
hygiene, and follow these practices yourself.

It can be hard to tell if an animal has ringworm, but a common sign of infection
is bald patches. Avoid petting any animals that have patches of skin showing
through their fur. Maintain regular checkups for all pets and ask your
veterinarian to check for ringworm.

Nursing intervention

1. Be patient and continue taking all medication as directed.

2. Your doctor may want to check you or your child in 4 to 6 weeks to

make sure the infection is clearing up.

3. Your child can usually return to school once they start treatment for
ringworm, but you should ask your doctor when it’s safe for them to
return.
4. Pets and other family members should be examined and treated if
necessary. This will help prevent reinfection.

5. Do not share towels, combs, hats, or other personal items with other
family members.

6. You can sterilize combs and brushes that belong to the infected person
by soaking them in bleach water. Follow the directions on the bleach
container for the proper dilution ratio.

7. Avoid petting any animals that have patches of skin showing through
their fur.

8. Maintain regular checkups for all pets and ask your veterinarian to check
for ringworm.
What causes athlete’s foot?
Athlete’s foot occurs when the tinea fungus grows on the feet. You can catch
the fungus through direct contact with an infected person, or by touching
surfaces contaminated with the fungus. The fungus thrives in warm, moist
environments. It’s commonly found in showers, on locker room floors, and
around swimming pools.

What are the symptoms of athlete’s

foot?
There are many possible symptoms of athlete’s foot, which include:

 itching, stinging, and burning between your toes or on soles of your feet
 blisters on your feet that itch
 cracking and peeling skin on your feet, most commonly between your toes
and on your soles
 dry skin on your soles or sides of your feet
 raw skin on your feet
 discolored, thick, and crumbly toenails
 toenails that pull away from the nail bed

How is athlete’s foot diagnosed?

A doctor may diagnose athlete’s foot by the symptoms. Or, a doctor may order
a skin test if they aren’t sure a fungal infection is causing your symptoms.
A skin lesion potassium hydroxide exam is the most common test for athlete’s
foot. A doctor scrapes off a small area of infected skin and places it in
potassium hydroxide. The KOH destroys normal cells and leaves the fungal
cells untouched so they are easy to see under a microscope.

How is athlete’s foot treated?

Athlete’s foot can often be treated with over-the-counter (OTC) topical
antifungal medications. If OTC medications don’t treat your infection, your
doctor may prescribe topical or oral prescription-strength antifungal
medications. Your doctor may also recommend home treatments to help clear
up the infection.

OTC medications

There are many OTC topical antifungal medications, including:

 miconazole (Desenex)
 terbinafine (Lamisil AT)
 clotrimazole (Lotrimin AF)
 butenafine (Lotrimin Ultra)
 tolnaftate (Tinactin)

Find these OTC antifungal medications on Amazon.

Prescription medications

Some of the prescription medications your doctor may prescribe for athlete’s
foot include:
 topical, prescription-strength clotrimazole or miconazole
 oral antifungal medications such as itraconazole
(Sporanox), fluconazole (Diflucan), or prescription-strength terbinafine
(Lamisil)
 topical steroid medications to reduce painful inflammation
 oral antibiotics if bacterial infections develop due to raw skin and blisters

Home care

Your doctor may recommend that you soak your feet in salt water or
diluted vinegar to help dry up blisters.

Alternative therapy

Tea tree oil has been used as an alternative therapy for treating athlete’s foot
with some success. A study from 2002 reported that a 50 percent solution of
tea tree oil effectively treated athlete’s foot in 64 percent of trial participants.

Ask your doctor if a tea tree oil solution can help your athlete’s foot. Tea tree
oil can cause contact dermatitis in some people.

Prevention
There are several things you can do to help prevent athlete’s foot infections:

 Wash your feet with soap and water every day and dry them thoroughly,
especially between the toes.
 Wash socks, bedding and towels in water that’s 140°F (60°C) or higher.
Combining washing socks and application of OTC antifungal
 recommendations should treat most cases of athlete’s foot. You can
disinfect your shoes by using disinfectant wipes (like Clorox wipes) or
sprays.
 Put antifungal powder on your feet every day.
 Don’t share socks, shoes, or towels with others.
 Wear sandals in public showers, around public swimming pools, and in
other public places.
 Wear socks made out of breathable fibers, such as cotton or wool, or made
out of synthetic fibers that wick moisture away from your skin.
 Change your socks when your feet get sweaty.
 Air out your feet when you are at home by going barefoot.
 Wear shoes made of breathable materials.
 Alternate between two pairs of shoes, wearing each pair every other day, to
give your shoes time to dry out between uses. Moisture will allow the
fungus to continue to grow.
Candidiasis of the Skin
(Cutaneous Candidiasis)
What causes candidiasis of the skin?
Candidiasis of the skin develops when the skin becomes infected
with Candida. A small amount of Candida fungi naturally live on the skin.

What are the symptoms of

candidiasis of the skin?
The main symptom of candidiasis of the skin is a rash. The rash often causes
redness and intense itching. In some cases, the infection can cause the skin
to become cracked and sore. Blisters and pustules may also occur.

The rash can affect various parts the body, but it’s most likely to develop in
the folds of the skin. This includes areas in the armpits, in the groin, between
the fingers, and under the breasts. Candida can also cause infections in the
nails, edges of the nails, and corners of the mouth.

Other conditions that may resemble candidiasis of the skin include:

 ringworm
 hives
 herpes
 diabetes-related skin conditions
 contact dermatitis
 seborrheic dermatitis
 eczema
 psoriasis

How is candidiasis of the skin

diagnosed?
Your doctor will likely be able to make a diagnosis simply by performing a
physical examination. During the exam, they’ll inspect the location of your
rash and the appearance of your skin.

Your doctor may also want to perform a skin culture before making a
diagnosis of candidiasis of the skin. During a skin culture, your doctor will rub
a cotton swab over the affected area and collect a skin sample. The sample
will then be sent to a laboratory to be tested for the presence of Candida.

How is candidiasis of the skin

treated?
Candidiasis of the skin can usually be prevented with home remedies, the
most important of which is proper hygiene. Washing the skin regularly and
drying the skin thoroughly can prevent the skin from becoming too moist. This
is vital to keeping Candida infections at bay.

There are many lifestyle changes you can make to both prevent and treat a
candidiasis infection.
Since abnormal blood sugar levels can contribute to the development
of Candida infections, keeping your blood sugar under control may also help
relieve symptoms. You may be able to lower your blood sugar by reducing the
amount of sugar in your diet and by exercising for 30 minutes at least three
times per week. If you have diabetes, it’s important to continue following your
doctor’s instructions as you may need to start receiving oral medications or an
increased amount of insulin.

In severe or persistent cases of candidiasis, your doctor may recommend

using an antifungal cream or powder that can be applied to your skin. Over-
the-counter antifungal creams that are often recommended include
clotrimazole (Mycelex), miconazole (Monistat), and tioconazole (Vagistat).
This type of treatment can kill Candida and reduce the spread of the infection.

Your doctor may prescribe an antifungal cream such as nystatin

or ketoconazole if the over-the-counter treatments aren’t effective. If the
infection has already spread to areas inside your body, such as your throat or
mouth, you may need to take an oral antifungal to get rid of it.

Nursing intervention
1. Natural topical remedies that may be used to treat a mild
cutaneous Candida infection include apple cider vinegar, coconut
oil, garlic, and tea tree oil.

2. Good idea to test them out on a small area first to check for an
allergic reaction or sensitivity.

3. The Candida cleanse is a special diet that severely restricts sugar,

refined flour, grains, dairy products, alcohol, and processed foods.
It allows mainly vegetables and herbs.