Recurrent Yeast Infections and Primary Immunodeficiency: What To Know

If you keep getting yeast infections, it might not be a coincidence. Many people with primary immunodeficiency (PI) face this frustrating problem, which can cause itching, pain, and stress. For some, these infections can also be hard to clear.

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Yeast infections that recur (keep coming back) can be a sign that your immune system is out of whack. In this article, we’ll explain how recurrent yeast infections are connected to PI disorders. We’ll also share personal experiences from others living with this issue, along with tips to help you find answers, get support, and feel better.

What Is a Yeast Infection?

Yeast infections — also called candidiasis — occur when a fungus called Candida grows too much in the body. It’s normal to have low levels of Candida on the skin, in the mouth, and in the genital area. However, when the fungus grows out of control, it can cause troublesome symptoms such as:

• Itching or burning in the affected area
• Thick, white vaginal discharge
• Discoloration, irritation, or swelling
• Cracked skin or painful rashes (especially in skin folds)
• Oral thrush (white patches in the mouth)
• Brittle, thick, discolored nails

A recurrent yeast infection returns at least four times a year. These infections can show up in different places, including the mouth (thrush), skin folds, genitals, nails, and even the gut. You might also feel tired, uncomfortable, or generally unwell.

If you’ve received proper treatment but still get recurrent infections — or ones that spread to unusual places — that’s a red flag. It could mean that your immune system is having trouble keeping the fungus in check.

One member of MyLupusTeam, an online community for people with lupus, shared their experience with recurrent infections: “Been fighting infections — three in total — in my bladder, lymphatic system, and kidneys. It’s been tough, but I’ve been resting, eating well, and drinking lots of water. I’m slowly getting better.”

Another member, who was also wondering about urinary tract infections (UTIs), asked, “How many of you have recurring UTIs and yeast infections?”

Reasons Yeast Infections Occur With Primary Immunodeficiency

Your immune system is your body’s defense system against germs like viruses, bacteria, and fungi, including Candida albicans. If you have a PI disorder, certain parts of your immune system don’t work as well as they should. Commonly affected parts include:

• T cells — Find and destroy infected or dangerous cells
• B cells — Make antibodies (immune proteins)
• Antibodies — Work like tiny flags to mark targets for the immune system
• Neutrophils (a type of white blood cell) — Act as first responders at the first sign of infection

When even one of these cell types is missing or damaged, it can be harder for the body to keep fungal infections under control.

Primary Immunodeficiency Disorders That Cause Recurrent Yeast Infections

More than 500 PI disorders have been identified. Repeated infections are common in many of them, but certain conditions are more strongly linked to recurrent or severe yeast infections.

Chronic Mucocutaneous Candidiasis

In chronic mucocutaneous candidiasis (CMC), a rare type of PI in which T cells don’t work properly, the body has a hard time fighting off Candida. People with CMC often get repeated fungal infections on the skin, nails, scalp, and inside the mouth. Diaper rashes, vaginal yeast infections, or thick, painful nail infections may start in early childhood and be tough to treat. Rarely, the infection may spread to the bloodstream or internal organs.

Treatment often includes long-term antifungal medication. Some people may also need immunoglobulin therapy (a type of immune therapy) or treatment for related autoimmune conditions such as diabetes or thyroid problems.

Chronic Granulomatous Disease

Chronic granulomatous disease (CGD), another rare form of PI, affects how certain white blood cells, called phagocytes, work. Phagocytes normally find and kill harmful bacteria and fungi. When these white blood cells don’t function correctly, a person is more likely to get repeated infections, including Candida infections.

CGD can also lead to abscesses (painful pockets of pus), lung infections, and swollen lymph nodes. Doctors usually treat CGD with long-term antibiotics and antifungal medicines. In some cases, a bone marrow transplant may be done to rebuild the immune system.

T-Cell Deficiencies

T cells are an important part of the immune system because they help the body find and fight off infections, including Candida. When someone has a T-cell deficiency, they may have too few working T cells or T cells that don’t function properly.

A T-cell deficiency can lead to serious or frequent infections, including recurrent yeast infections. Common T-cell-related conditions include:

• Severe combined immunodeficiency (SCID) — A life-threatening disorder in which neither T cells nor B cells work properly
• DiGeorge syndrome (also called 22q11.2 deletion syndrome) — A genetic condition that can cause heart defects, developmental delays, and low T-cell counts
• Wiskott-Aldrich syndrome — A rare genetic disorder that causes immune problems, easy bleeding, and eczema
• Hyper-IgE syndrome — A condition marked by high levels of immunoglobulin E (IgE) antibodies, frequent infections, and skin problems
• X-linked hyper-IgM immunodeficiency — A disorder in which the body makes too much IgM but not enough of other important antibodies

People with T-cell deficiencies may also get thrush, skin infections, sinus infections, or pneumonia early in life. These infections can be difficult to treat with standard medicines. Treatment often starts with antifungal medications or immunoglobulin therapy.

Warning Signs That Yeast Infections May Be Immune-Related

Yeast infections are common, often easily treated, and usually not a major health concern. However, when they don’t behave like a typical infection, it might be a clue that something is affecting your immune system. You may want to talk with your doctor if you notice:

• Yeast infections that spread beyond the usual areas
• Symptoms that don’t improve with antifungal treatment or come back quickly after treatment ends
• A pattern of multiple types of infections, including bacterial, viral, and fungal types
• A personal or family history of unusual infections or known immune conditions
• Unusual responses to vaccines, such as poor protection or severe side effects
• Ongoing inflammation, unexplained rashes, or autoimmune symptoms

These signs don’t always mean there’s a serious problem, but they should be checked out. If your doctor suspects an issue with your immune response, they may order blood tests or refer you to an immunologist (immune system specialist) for further evaluation. Early diagnosis and treatment can lead to better outcomes and fewer complications.

Living With Primary Immunodeficiency and Recurrent Yeast Infections

Managing PI and recurrent yeast infections can feel overwhelming, but you can take steps to protect your health.

No matter which type of PI you have, the most common treatment for recurrent yeast infections is long-term antifungal medication. Some people use creams or mouth rinses. Others may need a daily pill such as fluconazole, especially if infections are severe or come back often.

If your immune system doesn’t make enough working antibodies, your doctor may recommend immunoglobulin therapy to help your body fight off infections more effectively. For some people with serious forms of PI, a bone marrow transplant may be considered.

Prevention matters, too. Consider these tips to help reduce your risk of yeast infections in PI:

• Keep skin folds clean and dry.
• Wear light, breathable clothing.
• Avoid unnecessary antibiotics and steroids.
• Eat a balanced diet to support immune function.
• Get recommended vaccines, based on your doctor’s guidance regarding which are safe for you.

If you or your child has PI, regular check-ins with your healthcare team can help monitor immune health and keep infections under control. With the right care plan in place, many people with PI live full, active lives.

Join the Conversation

On myPIteam, people come together to learn more about life with primary immunodeficiency disorders.

Have you or a loved one experienced repeated yeast infections? What treatments have worked? Let others know in the comments below.