Candidiasis refers to a fungal infection caused by the yeast Candida albicans. Other species of Candida are occasionally causative. When seen in the male genital area, it may have been acquired through intercourse with an infected partner. Alternatively, it may arise de novo. 

In its mildest form, the condition may be intermittent and transient. Candida most often infects warm, moist, occluded areas, and the proximal shaft of the penis, the scrotum, and the crural folds are frequently involved. Candidal balanitis is an infection of the glans penis. It occurs more frequently in uncircumcised males. Genital and crural candidiasis can be accompanied by burning and pruritus.

Immunocompromised populations are at an increased risk of developing candidiasis. These patients include those with diabetes, HIV, systemic lupus erythematosus (SLE), and obesity, and patients being treated with corticosteroids or chemotherapy. Many patients will first present with candidal infections while the underlying cause of their immunocompromised state remains unknown; therefore, it is imperative that the physician keep these causes in mind. Recent oral antibiotic therapy is a further predisposing factor.

Diabetes is recognized as a risk factor for candidal infections because of decreased vascularity and the increase in blood glucose, which provides the best growth media for Candida. Candidal infections are one of the first presenting signs of previously undetected diabetes. Excellent glucose control will decrease the rates of candidiasis.

Patients with HIV infection may first present with mucocutaneous candidal infections or genital candidiasis. High suspicion should be held for patients who have recurrent candidal infections along with other risk factors for the contraction of the virus. Early detection of HIV holds importance for patient management as well as containing the spread of the virus.

Patients with autoimmune conditions like SLE, rheumatoid arthritis, scleroderma, Goodpasture syndrome, and granulomatosis with polyangiitis who are being treated with corticosteroids are at an increased risk for candidal infections. As these patients are being treated with high levels of immunosuppressives, it is important to look for mucocutaneous and genital candidiasis.

Related topic: oral candidiasis