Genital Research Articles

When an inguinal hernia is more than just a hernia with ovary and fallopian tube involvement: a case report

BackgroundFinding an ovary and/or fallopian tube within an indirect inguinal hernia is a rare occurrence that can be detected incidentally during elective surgery or present as a medical emergency requiring immediate intervention. Hence, it poses a difficult clinical picture in a reproductive-age woman with groin mass.Clinical presentationWe describe the case of a 45-year-old Ethiopian woman of Amhara ethnicity who presented with a left inguinal swelling that persisted for 5 years. Physical examination revealed an irreducible, non-tender lump in the left groin and an ultrasonography scan confirmed the presence of an indirect inguinal hernia. The patient was then scheduled for elective hernia repair. During the surgery, both her left ovary and fallopian tube were found within the hernial sac. The contents were released from the sac, high ligation performed, and the inguinal floor repaired with mesh.DiscussionInguinal hernias in women are rare and often present a diagnostic challenge. Although the exact pathogenesis of inguinal hernias containing female genital organs is unknown, some risk factors have been postulated. Diagnosis should start with a physical exam and imaging, but many of the cases have been intraoperative surprises. Management is primarily surgical, ranging from simple reduction and hernia repair to salpingo-oophorectomy depending on the status of the hernia contents.ConclusionThis report emphasizes the importance of maintaining a high index of suspicion when examining females with inguinal hernias to ensure accurate diagnosis and management of tubo-ovarian hernias. Although rare, inguinal hernias containing female genital organs should be considered in the differential diagnosis of inguinal hernias, as early detection and appropriate surgical management can prevent potential complications.

Nutrition affects larval survival and the development of morphological traits in male and female flour beetles, but genital size and shape remains canalised.

The caloric content and macronutrient ratio of diet consumed is a major source of phenotypic variation in most animal populations. While these nutritional effects have been well-documented for a variety of life-history and morphological traits, the effects of nutrition on male genitals are poorly understood but genitals are thought to be more canalised than general morphology and hence less susceptible to variation in nutrition. Even less is known about the effects of nutrition on female genital form, which to our knowledge, have never been investigated. Here we tested for effects of juvenile dietary macronutrients (protein and carbohydrate) on larval survival, adult morphology, including genital size and shape in male and female flour beetles (Tribolium castaneum). We found there was nutritionally induced plasticity in larval survival and morphology, although the latter effect was variable, with body size being most responsive to dietary macronutrients and genital size and shape being least responsive. Functionally equivalent morphological traits in the sexes responded similarly to nutrition. Previously, we showed that the genitalia of male and female T. castaneum are subject to strong stabilising sexual selection, and our current findings suggest that developmental mechanisms reduce the nutritional sensitivity of male and female genitals, possibly to ensure matching during mating.

Penyuluhan Pentingnya Vaksin HPV untuk Mencegah Kanker Serviks Sedini mungkin di Kabupaten Takalar

Cervical cancer is one of the most common types of cancer in the female genital organs caused by human papillomavirus (HPV), and preventive measures are highly recommended rather than curative measures. Prevention efforts are still poorly understood, so education is needed to increase vaccination coverage. The aim of this service is to increase participants' understanding of cancer vaccines. This method was used to discuss with partners at SDN Pusat No. 1 Patalasang District. Takalar, and students and teachers participate. Participants' knowledge was assessed through pre-test and post-test. The test result in front of 6 teachers and 15 students was 71.4, increasing to 98.2 at the time of the test. All service participants were satisfied with the implementation of the service because they felt the information was very useful and they needed it. All participants feel the benefits of using the services. Participants hope to continue this service in the future with free pap smears and vaccinations. It can be concluded that advice on cancer prevention and vaccination increased participants' understanding from 71.4 to 98.2 and was highly appreciated by the participants.

Reproductive health in trans and gender diverse patients: Transgender medicine: contextual trans gynecology.

This manuscript aims to promote an understanding of the special needs of transgender and gender-diverse people by putting trans gynecology into context. By definition, medical interventions for transgender people are not different from the treatment of cisgender people but cannot be singled out as gender-affirmative treatment. Treatment is dedicated to an overarching goal beyond medicine, namely to enable and maintain social functioning under the signs of the social gender. It is therefore that this narrative overview intensively deals with the requirements of trans gynecology. Also, various gynecological disorders are touched upon, provided they are relevant to trans people. The different significance of gynecological symptoms for either trans men or trans women, and the effects of supraphysiological androgen treatment on hormone-sensitive tissue, are stressed. Transgender health care is not just gender-affirmative transitional care but is committed to a superior objective, often beyond a medical perspective: to create and maintain physical conditions for social functioning under the signs of the individually appropriate sex and to contribute to significantly reducing gender dysphoria. For these purposes, it is a prerequisite to have a distinct contextual understanding of the complex reality of transpeople and knowledge about the numerous facets of transgender healthcare. Gynecology for transgender and gender-diverse people does not differ greatly from gynecology for cisgender female patients except in goals and context. Relief from complaints derived from genital organs is, of course important, but for transpeople there always is an overarching gender dimension that sometimes complicates treatment and might give rise to misunderstandings. Also, minority stress caused by societal factors frequently impacts the mental and physical state of health negatively and needs to be considered. This paper focuses on the context of trans gynecology and addresses various contentual aspects for both transmale patients having left genital organs in situ and transfemale patients with gynecological demands. Gynecological topics are addressed, highlighting their relevance for transgender and gender-diverse people (TGD), including the effects of supra-physiological androgen exposure on ovaries and uterus, vaginal bleeding, pelvic pain under testosterone treatment, screening policies, and benign gynecological disorders as clinical manifestations may appear differently and treatment may be more burdensome.

Prognostic factors and clinical outcomes in Fournier’s Gangrene: a retrospective study of 35 patients

BackgroundFournier’s gangrene is a severe form of infectious necrotizing fasciitis affecting the perineum, perianal, and genital areas; it is associated with substantial morbidity and mortality. Hence, it is important to identify prognostic factors that can predict clinical outcomes and guide treatment strategies. Thus, our study aimed to analyze patient characteristics and determine prognostic factors affecting clinical outcomes in Fournier’s gangrene.MethodsThis retrospective study involved examining medical records spanning 18 years for patients with Fournier’s gangrene at our institution. Considering the exclusion criteria, data from 35 patients were included in this study.ResultsA total of 35 patients were included in the analysis. The mean age of the patients showed no statistically significant difference between the survivor and non-survivor groups. The Charlson Comorbidity Index, American Society of Anesthesiologists score, and Acute Physiology and Chronic Health Evaluation II score were not significantly different between the two groups. Notably, the initial Sequential Organ Failure Assessment score was significantly higher in the non-survivor group than that in the survivor group. The overall in-hospital mortality rate was 17.1%. Moreover, the prevalence of multidrug resistant bacterial infection was markedly higher in the non-survivor group than that in the survivor group. Coagulation dysfunction was significantly more prevalent in the non-survivor group than that in the survivor group, and had the most significant impact on in-hospital mortality. A multivariable logistic regression analysis identified multidrug resistant bacterial infection to be independently associated with high in-hospital mortality.ConclusionsCoagulation dysfunction and multidrug resistant bacterial infection were identified as independent negative prognostic factors, highlighting the need for prompt monitoring and proactive strategies against Fournier’s gangrene.

The impact of COVID-19 on the male reproductive system.

The relevance of the study is determined by the deepening understanding of the global consequences of the coronavirus pandemic, which affect not only lung health but also a wide range of other body systems. In light of new data on the long-term effects of coronavirus infection, this study is highly significant. The purpose of this study is to investigate the impact of coronavirus infection on the male reproductive system and assess its potential influence on male fertility to refine the mechanisms of damage and provide recommendations for medical care. The study utilised a combination of methods, including a meta-analysis of medical organisation databases, analysis of clinical cases, representative sample method, and quantitative survey method. These approaches allowed for a comprehensive and multifaceted view of the problem. The samples of sperm showed a noticeable decrease in progressive motility, sperm concentration, and volume, especially in patients with moderate and severe symptoms of COVID-19, whereas patients with mild symptoms only experienced a decrease in progressive motility and overall sperm motility. The survey identified symptoms of male reproductive system dysfunction after recovering from COVID-19. Predominant symptoms included decreased libido (15%), impotence (13%), and infections of the genital organs (12%). Most surveyed men lacked sufficient awareness of other aspects of male reproductive health, including infections, genetic defects, chronic diseases, and available medical services. As a result of the study, it was concluded that coronavirus infection can have a negative impact on the male reproductive system. The practical value of this study lies in improving approaches to medical care for men who have recovered from COVID-19 and creating preventive programmes.

Stimulatory Functions of Male Genitalia in Tipula (Triplicitipula) colei Alexander and Tipula (Lunatipula) translucida Doane (Diptera: Tipulidae) and Implications for Theories of Genital Evolution.

Male genitalia have been hypothesized to function as courtship devices during copulation, but it is difficult to use behavioral observations to test this hypothesis because male genitalia are usually hidden inside the female during copulation. In tipuloid flies, however, nearly all of the male's complex genital structures remain outside the female. Copulation behavior and genital morphology in Tipula (Triplicitipula) colei and T. (Lunatipula) translucida suggest that some male genital structures function to stimulate the female: male structures that contact the female bear tufts or dense arrays of modified setae on precisely the surfaces that contact the female; contact involves repeated, stereotyped rhythmic movements that include brushing, vibrating, scraping, and tapping; the movements are appropriately designed to utilize the morphology of the modified setae to stimulate the female; and the movements have little or no other perceptible mechanical effects on the female. The female structures contacted by these male genital movements fail to show the defensive designs predicted by the theories of genital evolution that are based on morphological species isolation or male-female morphological conflicts of interest; also unexplained by the conflict of interest hypothesis are female movements that seem designed to increase rather than avoid stimulation by the male.

Caught by a Medieval Disease: A Monoarthritis Revealing Syphilis

Syphilis is a sexually transmitted bacterial infection that first appeared in Europe in the 15th century, responsible for deadly epidemics before the discovery of penicillin. It typically progresses through three phases: primary syphilis, characterized by a syphilitic chancre that may appear on the genital area, anus, or oral cavity and can go unnoticed; secondary syphilis, which corresponds to the hematogenous dissemination of the treponema, leading to skin eruptions occurring in two waves, also known as "florid" phases, with the second wave being the most characteristic, involving papular lesions on the palms and soles. During this phase, there may also be lymphadenopathy, early neurosyphilis, and osteoarticular manifestations such as periostitis and arthritis [1,2,3]. Finally, tertiary syphilis, a historical form, is characterized by cardiac, vascular, and/or neuropsychiatric involvement. We report the case of a patient with risky sexual behavior who presented with an oral ulceration possibly corresponding to an oral syphilitic chancre in the primary phase. The patient did not seek medical attention at that time and developed secondary syphilis with joint involvement two months later. This article aims to remind that syphilis should not be excluded when faced with the combination of oral ulceration and arthritis, alongside chronic inflammatory bowel diseases, Behçet's disease, and lupus. The infection has to be confirmed in the joint aspiration either by isolating the treponema or by finding the pathogen’s DNA or simply by TPHA and VDRL technique ; as for the syphilitic arthritis should be treated as a secondary siphilis.

Overhauling dental implications in a child with rare craniofrontonasal syndrome: a case report

Craniofrontonasal syndrome is an extremely rare X-linked dominant genetic disorder characterized by features such as hypertelorism, craniosynostosis, ocular anomalies, a bifid nasal tip, and longitudinal ridging with splitting of the nails. Heterozygous females are more severely affected, presenting frontonasal dysplasia and coronal craniosynostosis (fusion of the coronal sutures), while males typically only exhibit hypertelorism. This case report describes the dental management of a 9-year-old female with craniofrontonasal syndrome who was referred to the department of paediatric and preventive dentistry for pain in the lower right and left back tooth region. The patient exhibited a clinical spectrum including microcephaly, short neck, axillary pterygium, clinodactyly of the toes, longitudinal ridging with split nails, pectus excavatum, and underdeveloped female genitalia. Extraoral examination revealed hypertelorism, flat nasal bridge, low-set ears, strabismus, antimongoloid slant, and an indistinct philtrum. Intraoral examination showed a high palatal vault, crowding of the upper and lower arches during the mixed dentition period, multiple dental caries, and poor oral hygiene. An orthopantomogram confirmed delayed dental development. Dental treatment was carried out on a dental chair system using adequate behaviour management techniques with short appointments, keeping in mind the reduced cooperative ability of the child. The importance of this report stems from the limited dental literature available on the syndrome. Preventive measures along with home care instructions were emphasized to support professional care.

Molecular species identification from seized dried genital organs: a case study of suspected Bengal monitor lizard (Varanus bengalensis)

The bifurcated hemipenes of any of the four species of Monitor lizards found in India is illegally traded under the name ‘Hatha Jodi’ (a plant root from Martynia annua). A rare plant root is misrepresented as a powerful charm capable of bringing property and good fortune to its possessor. As a result, there is a suspected large-scale poaching of monitors in India to fuel the trade of ‘Hatha Jodi’. With this regard, here we report a case where the Tamil Nadu Forest Department officers seized dried genital organs. We extracted DNA from the seized dried genital organs and amplified a partial fragment of the mitochondrial cytochrome-b gene (cytb). Then, generated DNA sequences were analyzed and confirmed that the dried genital organs were consistent with the Bengal monitor lizard with 99% similarity. In forensic case analysis, dried and processed samples are not preferred for DNA-based analysis. This is due to the low yield of DNA and increased PCR inhibitors, which lead to low success in such experiments. However, the present study demonstrated species identification through DNA analysis from seized dried genital organs and supported law enforcement in successfully prosecuting the case.

New species of Eupolyphaga Chopard, 1929 and Pseudoeupolyphaga Qiu & Che, 2024 (Blattodea, Corydioidea, Corydiinae), with notes on their female genitalia.

Two new species of Eupolyphaga (E.bicolor Han, Che & Wang, sp. nov. and E.nigra Han, Che & Wang, sp. nov.) and six new species of Pseudoeupolyphaga (P.flava Han, Che & Wang, sp. nov., P.deficiens Han, Che & Wang, sp. nov., P.magna Han, Che & Wang, sp. nov., P.longiseta Han, Che & Wang, sp. nov., P.latizona Han, Che & Wang, sp. nov., and P.baimaensis Han, Che & Wang, sp. nov.) are described and illustrated. The female external genitalia and spermathecae of these two genera are reported and the role of these characters in species delimitation is discussed.

The genera Chrysillaand Phintelloidesrevisited with the description of a new species (Araneae, Salticidae) using digital specimen DOIs and nanopublications.

Two Southeast Asian spider collections: that of Frances and John Murphy, now in the Manchester University Museum and the Deeleman collection, now at the Naturalis Biodiversity Center in Leiden constituted the basis of this analysis of Chrysilla Thorell, 1887 and related genera. The latter collection also includes many thousands of spiders obtained by canopy fogging for an ecological project in Borneo by A. Floren. Some incongruences within the genera of the tribe Chrysillini are disentangled. The transfer of C.jesudasi Caleb & Mathai, 2014 from Chrysilla as type species of Phintelloides Kanesharatnam & Benjamin, 2019, based on analysis of molecular data is validated by morphology. An interesting new species known only from the forest canopy in Borneo, Phintelloidesscandens sp. nov, is described based on both male and female specimens. Distinguishing chrysilline genera is mostly based on traditional somatic characters, e.g., habitus, carapace and abdomen patterns, mouthparts, and genital organs. The utility of two character systems for distinguishing chrysilline genera is highlighted: 1) the presence of a flexible, articulating embolic tegular branch (etb) in combination with the conformation of the characteristic construction of the epigyne in Chrysilla and Phintelloides; 2) presence of red colour on carapace and abdomen of live males and females, in combination with abundant blue/violet/white iridescent scales such as inChrysilla and Siler. The red colour usually gets lost in alcohol, hampering species identification of alcohol material. The genera Chrysilla andPhintelloidesare redefined. Specimens of the heretofore unknown female of Chrysilla deelemani Prószyński & Deeleman-Reinhold, 2010 are described. The male and female ofChrysillalauta and male of C.volupe are redescribed. The genus Chrysilla is diagnosed and discriminated from PhintellaBösenberg & Strand, 1906, SilerSimon, 1889, Phintelloides Kanesharatnam & Benjamin, 2019 andProszynskiaKanesharatnam & Benjamin, 2019. The structure of the female genital organ of Phintelloidesflavumi Kanesharatnam & Benjamin, 2019 is scrutinized and the generic placement of Phintelloides is discussed. Males and females of one of the most variable species, Phintelloidesversicolor (C. L. Koch, 1846) are redescribed.Phintelloidesmunita(Bösenberg & Strand, 1906) is removed from synonymy with P.versicolor. Phintellaleucaspis Simon 1903 (male, Sumatra) is synonymized withP.versicolor.Biodiversity data are increasingly reliant on digital infrastructure. By linking physical specimens to digital representations of their associated data, we can lower barriers to information flow. Here we demonstrate a workflow whereby persistent identifiers (PIDs) in the form of DOIs issued by DataCite are assigned to specimens. Recognized taxa are identified by their catalog of life identifier, or by registration in ZooBank where no catalog of life identifier is available. We demonstrate the use of nanopublications, creating a series of machine readable, scientifically meaningful assertions regarding the provenance and identification of cited specimens. All human agents associated with the specimen data are linked to a persistent identifier issued by either ORCiD or Wikidata.

Review of the genus Diduga (Lepidoptera, Erebidae, Arctiinae) of Vietnam, with a new species and two newly recorded species

Species of the genus Diduga Moore are reviewed in Vietnam, with nine species including a new species, D. laocai sp. nov., and two newly recorded species, D. hastata Bayarsaikhan & Bae, 2021 and D. robdevosi Bayarsaikhan & Bae, 2023. Illustrations of adults and male and female genitalia of all examined species are provided.

Is Chronic Pelvic Inflammatory Disease an Exclusively Medical Gynecological Disease, or It May Be a Surgical Challenge?

Pelvic inflammatory disease is an infectious condition affecting women’s upper genital tract, including the uterus, fallopian tubes, and ovaries. It primarily arises from an infection that spreads upward from the lower genital area. The relationship between chronic pelvic pain and coexisting conditions is a key focus in its diagnosis and treatment. This type of pain is also considered a form of reflex dystrophy, involving both neurological and psychological components, the first line treatment consists in antibiotherapy. For patients with complex or severe pelvic abscesses, surgical intervention may be considered in selected cases. The primary surgical techniques employed are open and laparoscopic surgery, both aimed for abscess removal. MRI or Doppler ultrasonography may be employed when there is a suspicion of adnexal torsion, adenomyosis or deep pelvic endometriosis, especially if the ultrasound results are unclear or inconclusive Laparoscopic surgery has increasingly become favored by both healthcare professionals and patients. Moreover, laparoscopy has emerged as the most valuable tool for diagnosing chronic pelvic pain. The approach to treating pelvic abscesses in women of reproductive age depends greatly on clinical assessments, individual patient factors, and the desire to preserve fertility. However, laparoscopy may present technical difficulties in patients with severe pelvic abscesses, particularly those with extensive adhesions or a closed-off pelvic area, requiring advanced surgical expertise. Women with associated conditions such as endometriosis often experience a more severe form of pelvic inflammatory disease, which is less responsive to antibiotics and more frequently requires surgical resolution. The surgical treatment should be performed individualized to the clinical condition of the patient and the time of intervention must be carefully chosen.

A nonhuman primate model for genital herpes simplex virus 2 infection that results in vaginal vesicular lesions, virus shedding, and seroconversion.

The most commonly used animal models for evaluating the efficacy of HSV-2 candidate vaccines are mice and guinea pigs. While numerous HSV-2 vaccine candidates have been tested in these animals and were effective in reducing disease and mortality, these results did not predict the effectiveness of the vaccines in human trials. Infection of rhesus macaques rarely results in lesions or HSV-2 specific antibody responses. In seeking an animal model that better recapitulates human disease and that might be more predictive of the efficacy of prophylactic vaccines than mice and guinea pigs, we evaluated Cebus apella (C. apella), a New World primate, in an HSV-2 genital infection model. Infectious HSV-2 was cultured from vaginal swabs from all 4 animals for 9-14 days after intravaginal inoculation of HSV-2 seronegative monkeys. Two of 4 monkeys had vesicular lesions in the vagina or vulva. No neurological symptoms were noted. Recurrent lesions and HSV-2 DNA shedding after acute disease resolved was infrequent. UV irradiation of the genital area did not induce recurrent genital lesions or virus shedding. All 4 monkeys developed HSV-2 neutralizing antibodies as well as virus-specific CD4 and CD8 T cell responses. Reinfection of animals 15 to 19 months after primary infection did not result in lesions; animals had reduced virus shedding and a shorter duration of shedding compared with that during primary infection, suggesting that primary infection induced protective immunity. Primary fibroblasts from C. apella monkeys supported the growth of HSV-2 in vitro; in contrast, HSV-2 did not replicate above the titer of the input inoculum in fibroblasts from rhesus macaques. These observations suggest that the C. apella monkey has potential to serve as a model for evaluating the efficacy of prophylactic vaccines, antivirals, or monoclonal antibodies to HSV-2.

Taxonomic status of the genus Lunakia, including a redescription of the male and female genitalia of Lunakia alyssella (Klimesch, 1941) (Lepidoptera, Plutellidae)

The genital morphology of the Lunakia alyssella (Klimesch, 1941) is redescribed. Additional details of both male and female genitalia are provided, supplemented with accompanying drawings. Anatomical evidence confirms that the genus Lunakia is distinct from the genus Eidophasia within the family Plutellidae. Males are characterized by long, curved appendages of the tegumen, and females by the antrum with a subgenital plate.

Morphological diversification with emphasis on the structural and homology patterns of male genitalia in genus Limnebius (Leach 1815; Hydraenidae: Coleoptera)

Abstract Limnebius exhibits uniform external appearance but variable male genitalia: from differently curved rod shapes in the subgenus Bilimneus to up to seven longitudinally separated folds or appendages in Limnebius s.s.. Among nonsexual traits, two subgenera diverge only in the wing. The aedeagal complexity in Limnebius s.s. is associated with the secondary sexual structures on the abdomen and metatibia; larger body size, which forms two clusters; and male-biased sexual dimorphism. To cluster the subdivisions with phylogenetically unresolved relationships, we examined the coincidence of the traits in both sexes, based on the premise of the independent and monophyletic origin of histologically unsimilar elements. The folds and additional appendages on the median lobe, abdominal paired rows of setae, and protuberances show that the L. parvulus and L. nitidus groups have maximum aedeagal complexity in the L. parvulus and L. nitiduloides subgroups, respectively. The L. parvulus group exhibits a gradual increase in the number of elements of the aedeagi. The histology of connections of the parameres and additional appendages to the median lobe, along with that of the flagellum opening, reveal the subgroups’ relationship in the L. nitidus group, as well as a decrease in the complexity of the male genitalia in their recent branches.

Review of the genus Salicarus (Hemiptera, Heteroptera, Miridae).

The genus Salicarus Kerzhner, 1962 is revised, with differential diagnoses and redescriptions provided for nine species. Three distinct species groups were recognized within the genus: S.nitidus group (S.cavinotum, S.genistae, S.nitidus, S.perpusillus), S.roseri group (S.concinnus, S.roseri, S.urnammu), and S.fulvicornis group (S.halimodendri, S.fulvicornis). A key to species, illustrations of dorsal habitus, male and female genitalia, and selected diagnostic structures are included. Additionally, available host information and distributional records are summarized. Phoenicocorisqiliananus Zheng, 1996 is synonymized with Salicarushalimodendri V. G. Putshkov, 1977.

Pornography consumption and its effect on sexual performance in young men: Urology point of view

AbstractChronic pornography use is a public health problem that has considerable effects on men's health, especially on their sexual performance, having effects that can be encompassed from a biological, social, and psychological approach. Our objective was to conduct a literature review to evaluate the consequences in terms of sexual performance of young men who have chronic consumption of pornography. Chronic pornography consumption was related to erectile dysfunction, premature ejaculation, and alterations in genital anatomy and physiology. Social and psychological effects were also found, such as increased rates of violence towards women, problems with partners, and intimacy. However, benefits of controlled consumption of pornography have also been identified, such as reaffirmation of sexual orientation, stimulation of self‐discovery of the body, and improved communication with partners. Chronic consumption of pornography has direct effects on the sexual performance of young people and should be evaluated by a multidisciplinary team that includes physiological, social, and psychological elements. However, its use may be recommended for people with psychological problems, urological problems, and urological cancer.

Incidence of Candidiasis and Associated Risk in Diabetic Patients

Candida causes candidiasis. The genus Candida contains about 200 different species, but only a small proportion of Candida are dangerous and cause more external or internal diseases when they enter the body. Candida albicans is a ubiquitous pathogen, associated with many bacteria in the mouth, throat, and intestines. The immune system and the bacteria present are monitored for Candida, and damage to the immune system or changes in the bacteria can cause Candida to become infected. In general, these infections are limited to the mouth, genital area, and skin, but people with cancer or other serious diseases, such as HIV, have very weak immune systems which make them suffer from more serious diseases.