Candidiasis is an infection caused by a species of Candida (most often C. albicans), manifested by lesions of the mucocutaneous tissue, fungemia and sometimes focal infection with the involvement of various organs in the process. Symptoms include dysphagia, skin and mucosal lesions, blindness, vaginal signs (itching, burning, discharge), fever, shock, oliguria, kidney failure, and disseminated intravascular coagulation. The diagnosis is confirmed by histological methods and cultures from usually sterile sites. Treatment is with amphotericin B, fluconazole, echinocandins, voriconazole, or posaconazole.
The yeast Candida albicans is a normal symbiote of the oral cavity, but under certain conditions it multiplies, causing thrush. This occurs in children, weakened persons, patients receiving glucocorticoids or antibiotics, patients with diabetes mellitus or with suppressed immunity, especially in treatment with cytostatics, as well as in AIDS. On the tongue and mucous membrane of the cheeks, white foci are found. Odinophagia and dysphagia make it possible to suspect candidiasis of the pharynx and esophagus. A clinical diagnosis is sufficient to initiate treatment, although a smear or biopsy may be taken for mycological examination to verify the diagnosis.
Oral thrush is treated with nystatin or amphotericin B in suspension or tablets. In resistant cases or patients with immunosuppression, oral fluconazole is prescribed.
Candida species are associated organisms that inhabit the gastrointestinal tract and sometimes the skin. Candidiasis is a consequence of the activation of endogenous fungi. Most infections are caused by C. albicans or C. tropicalis; however, C. glabrata (formerly Torutopsis glabrata) is increasingly associated with fungal urinary tract infection, pneumonia, or other focal lesions.
Candidiasis, which affects the mouth and esophagus, is an opportunistic infection in AIDS. Although mucocutaneous candidiasis is common in HIV-infected patients, hematogenous spread is uncommon until immunosuppression becomes profound. Patients with neutropenia (eg, those receiving chemotherapy for cancer) are at a high risk of developing life-threatening disseminated candidiasis.
Treatment consists in the use of drying agents and antifungal drugs.
In most cases, candidiasis affects only the skin and mucous membranes, but patients with immunosuppression often experience an invasive course of an infectious disease that can be life-threatening.
Causes of candidiasis
There are 196 known species of fungi of the genus Candida albicans.
They may be:
- on the skin;
- on mucous membranes;
- on products;
- on household items.
May be in the gastrointestinal tract. Normally, they can be on the skin and mucous membranes and, with a decrease in immunity, cause a disease.
Contribute to the development of the disease:
- the use of antibiotics;
- hormonal drugs;
- immunosuppressants;
- cytostatics;
- antimetabolites;
- hypoparathyroidism;
- hypothyroidism;
- violation of carbohydrate metabolism;
- violation of protein formation due to the liver;
- SIBR;
- skin injuries, burns of mucous membranes;
- maceration;
- contact with acids, alkalis, essences;
- warm humid climate;
- violation of hygiene;
- alcohol, drugs;
- hypo-, avitaminosis.
Candidemia may occur in patients without neutropenia during a long hospital stay. This infection is often associated with one or more factors:
- Multiple injuries.
- Operations.
- Multiple courses of broad spectrum antibiotic therapy.
- Intravenous or parenteral nutrition.
Intravenous punctures and GI tract infections are common sites of infection. Candidemia often prolongs hospitalization and increases mortality due to comorbid conditions. Long-term or untreated candidemia can lead to endocarditis or meningitis, as well as to focal lesions of the skin, subcutaneous tissue, bones, etc. Endocarditis is commonly associated with intravenous drug abuse, valve replacement, or intravascular trauma caused by the constant presence of an intravenous catheter inside.
All forms of disseminated candidiasis should be considered serious, progressive and potentially fatal.
Candida is a group of about 150 yeast species. C. albicans causes about 70-80% of all candidiasis cases. Other important species include C. glabrata, C. tropicalis, C. krusei, and C. dubliniensis.
Candida is an ubiquitous yeast that lives on the skin and mucous membranes without causing harm as long as increased humidity, warmth and disruption of local and general defense mechanisms create favorable conditions for the reproduction of the pathogen. Risk factors for developing candidiasis include:
- hot water;
- tight clothing;
- poor personal hygiene;
- sometimes a rash in the diaper area in children or underwear in adults;
- violation of flora against the background of antibiotic therapy;
- inflammatory diseases (for example, psoriasis), immunosuppression caused by the use of glucocorticosteroids and immunosuppressive drugs, pregnancy, diabetes, other endocrinopathies, blood dyscrasia.
Candidiasis most commonly occurs in intertriginous areas such as the axillary fossa, groin, and gluteal folds (eg, diaper rash), interdigital folds, glans, and folds under the mammary glands. Vulvovaginal candidiasis is common in women. After an improperly done manicure, dishwashers and people who are often forced to work with their hands in water may develop candidiasis of the nail plates and paronychia. In obese patients, candidal infection can occur in the folds of the abdomen. Oropharyngeal candidiasis is a common symptom of local or systemic immunosuppression.
Chronic mucocutaneous candidiasis usually affects the nails, skin, and oropharynx. Patients have no protective skin reactions against Candida, there is no proliferative response to the Candida antigen (but the normal proliferative response to mitogens remains), and the antibody response to Candida antigens and other antigens is preserved. Chronic mucocutaneous candidiasis can develop as an autosomal recessive disease associated with hypoparathyroidism and Addison's disease (Candida-endocrinopathy syndrome).
Pathogenesis:
- attachment (adhesion) of fungi to mucous membranes - no clinical manifestations;
- dissimation into various organs and systems. More often children and the elderly, obese people get sick
Symptoms and signs of candidiasis
The clinic has several forms:
- oral candidiasis - thrush;
- candidiasis of skin folds, nails, periungual ridges;
- candidal angina;
Esophagitis is most often manifested by dysphagia. Airway symptoms (eg, cough) are nonspecific.
Candidemia usually presents with fever, but there are no specific symptoms. Some patients develop a bacterial sepsis-like syndrome with a rapid course, which may include shock, oliguria, renal failure, and disseminated intravascular coagulation.
Candidal endophthalmitis begins as white lesions of the retina that are initially asymptomatic, but can progress to cloudy eyes and potentially irreversible processes to the point of blindness. Patients with neutropenia sometimes also have retinal hemorrhages, but actual eye infection is rare.
Papulo-nodular skin lesions may also develop, especially in neutropenic patients, in whom they indicate widespread hematogenous spread to other organs. The symptoms of focal infection depend on the organ affected.
Intertriginous infection manifests itself in the form of itchy erythematous spots of various sizes and outlines with clear boundaries; erythema can be difficult to detect in dark-skinned patients. Primary blemishes may be accompanied by satellite papules or pustules on adjacent skin areas. With perianal candidiasis, areas of whitish maceration are formed, accompanied by itching in the anus. With vulvovaginal candidiasis, itching and discharge are noted.
Candidal infection is a common cause of chronic paronychia, which is manifested by the formation, soreness, redness and swelling of the periungual fold. Subungual infections are characterized by detachment of the distal portions of one or more nails (onycholysis) with white or yellow coloration of the subungual area.
With oropharyngeal candidiasis, white plaques appear on the oral mucosa, which can bleed when scraped.
Seizures are candidiasis in the corners of the mouth, which causes large and small cracks to appear. It can be caused by chronic lip licking, finger sucking, wearing poorly fitted dentures, or other conditions with high moisture in the corners of the mouth that encourages yeast growth.
Chronic mucocutaneous candidiasis is characterized by the formation of red thick plaques with pustules and crusts on the surface, resembling psoriasis, especially on the skin of the nose and forehead, and is necessarily accompanied by chronic candidiasis of the oral mucosa.
Candidiasis of children
The newborn becomes infected in the birth canal, through the chest, diapers, hands.
As a result, develop:
- thrush;
- diaper rash;
- stomatitis.
- dry mucous membranes;
- redness;
- white bloom;
- white-gray films, easily detachable, resulting in bleeding erosion;
- glossitis is possible;
- there may be "seizures";
- the skin and mucous membranes are macerated, blotchy, painful, crusting.
Professional candidiasis
- from winemakers;
- cannery workers;
- confectioners.
- paronychia;
- onychia - nail damage (nails become thinner, transverse brown grooves appear);
- defeat of the interdigital spaces.
Sore throat
White, shiny corks are formed. The tonsils are enlarged, red, painless; temperature is normal; may be chronic.
Chronic generalized candidiasis
Chronic generalized candidiasis develops:
- in persons with IDS;
- with insufficient function of the parathyroid glands.
- thrush;
- cheilitis (damage to the mucous membrane of the lips);
- nails thicken, deformed, crumble, bumpy;
- rashes, ulcers, bumps on the skin;
- there may be pneumonia, bronchitis, myocarditis.
Visceral candidiasis
With candidiasis of the gastrointestinal tract, the following develop:
- esophagitis;
- gastritis;
- cholecystitis;
- enterocolitis.
- decreased appetite;
- difficulty swallowing;
- vomiting;
- diarrhea with mucus;
- flatulence.
There may be ulcers, as in stomach ulcers.
Respiratory candidiasis
With candidiasis of the respiratory system, the following develop:
- laryngitis;
- pharyngitis;
- bronchitis;
- pneumonia.
Genitourinary candidiasis
With candidiasis of the genitourinary system, the following develop:
- urethritis;
- cystitis;
- pyelitis;
- vulvovaginitis;
- balanoposthitis.
Candidiasis of ENT organs, eyes
There may be candidiasis of ENT organs, eyes.
Developing:
- meningitis;
- meningoencephalitis;
- candidosepsis;
- allergic forms with bronchospasm and rashes.
Visceral forms are secondary. With long-term antibiotic treatment, small-focal pneumonia with cavities develops.
Vaginal candidiasis
- physiological immunodeficiency;
- immunodeficiencies (congenital and acquired);
- oncological diseases;
- chemotherapy, radiation therapy, steroid use;
- diseases of the internal organs;
- unbalanced diet;
- uncontrolled intake of antibiotics.
Candidiasis in pregnant women
Candidiasis in pregnant women develops due to:
- changes in hormonal balance;
- increased progesterone;
- SIBR.
- cheesy discharge;
- itching, more often at night;
- burning;
- unpleasant odor;
- frothy discharge when using candles, creams. There may be a relapse and risk of fetal damage.
Vaginosis can affect teenage girls. It is combined with obesity, diseases of the gastrointestinal tract, hyperplasia of the thyroid gland and its hypofunction. These are girls at risk of pregnancy and childbirth for infectious complications. Three forms of vaginal infection:
- asymptomatic candidal carriage and fungi are detected in a low titer, the number of lactobacilli increases;
- true candidiasis - fungi as a mono-pathogen, and there are more than 104 CFU / ml, and lactobacilli more than 106 CFU / ml.
- combination of vaginal candidiasis with bacterial vaginosis, there are fungi and obligate anaerobes and gardanelles with a decrease or absence of lactobacilli.
Clinical forms of genital candidiasis:
- candidiasis;
- chronic recurrent urogenital candidiasis. There is a combination of candidiasis with bacterial opportunistic microflora.
Candidiasis diagnosis
- Histopathology and fungal cultures.
Because Candida is a commensal species, cultured exposure to saliva, mouth, vagina, urine, stool, or skin does not necessarily indicate an invasive progressive infection. Characteristic clinical manifestations are required; histopathological evidence of tissue invasion should be obtained (eg, yeast, pseudohyphae, or hyphae in tissue specimens), and other infections should be excluded. A positive culture of blood, CSF, pericardial or pericardial fluid, or tissue biopsies provides clear evidence that systemic therapy is needed.
Serologic tests do not have sufficient specificity or sensitivity.
The diagnosis is based on clinical data and the identification of yeast and pseudohyphae during microscopic examination of scrapings from the lesion in a wet preparation with potassium hydroxide.
Diagnostics based on:
- passport data (where he lives and who works);
- clinical data;
- laboratory data:
- microscopic examination of plaque;
- immune;
- cultural;
- immune-enzymatic;
- serological research - but there should be a clinical picture (fungi develop in healthy people).
Treatment of candidiasis
- Amphotericin B in severe disease, in other cases echinocandin or azole.
Predisposing conditions (eg, neutropenia, immunosuppression, use of a wide range of antimicrobial antibiotics, parenteral nutrition, permanent catheterization sites) should be controlled. Intravenous amphotericin B is recommended in most critically ill patients, especially with weakened immunity. Echinocandins are an alternative to amphotericin B for adults with or without neutropenia. Fluconazole is also considered a first-line drug (unless C. krusei or C. glabrata is involved) for patients without neutropenia. The drug may also be effective in neutropenic patients.
Esophageal candidiasis is treated with fluconazole or itraconazole. If these drugs are ineffective or if the infection is severe, voriconazole, posaconazole, or one of the echinocandins may be used. These drugs are also effective for other hematogenously disseminated mycoses.
Intertriginous infection is treated, if necessary, with drying agents (for example, Burov's solution when rashes become wet, gentian violet in the area of \u200b\u200binterdigital folds) and external antifungal drugs. The powder form is ideal for treating dry lesions. Taking fluconazole is indicated for advanced candidiasis; at the same time, you can use external antifungal drugs.
In the treatment of candidiasis in the diaper area, diapers are changed more often, plastic-coated disposable diapers are abandoned, and imidazole cream is applied. Newborns with concomitant oropharyngeal candidiasis may be given oral nystatin.
Candidal paronychia is treated with topical or systemic antifungal drugs, protecting the affected area from contact with water. This disease is often resistant to therapy.
Oral mucosa candidiasis Treat with fluconazole.
Chronic mucocutaneous candidiasis requires long-term therapy with oral antifungal drugs: ketoconazole or itraconazole.
Candidiasis is a rather unpleasant disease, which is popularly called thrush. This ailment affects not only women, men can also suffer from the symptoms of this disease. For the first time, young people encounter such a problem at the age of 15-17 to 25, and if at this time adequate treatment for candidiasis was not carried out, the pathology can take on a chronic course. In most cases, incorrect or untimely therapy for thrush leads to frequent relapses of the disease in the future. “So what to do when signs of this ailment appear? And how to choose the right treatment tactics for candidiasis? " - you will learn useful information about this disease after studying this article.
General information about pathology
What is candidiasis? This is how doctors call a disease caused by fungal microorganisms of the Candida albicans species. Candida is a conditionally pathogenic fungus that lives on the skin and mucous membranes of the human body, being an integral part of its normal, familiar microflora.
But in this case, what causes candidiasis? The symptoms of such an ailment are due not so much to the presence of a fungus as to its uncontrolled reproduction or infection with more harmful strains of these microorganisms. If candida enter the body from the external environment, then an infected person usually becomes their source. Fungal infection is transmitted by close contact, the sexual route of infection is especially popular. On the mucous membranes and skin of healthy people, such microbes are contained in extremely small quantities - which makes them absolutely harmless. The uncontrolled development of fungi is inhibited by beneficial bacteria, so, under normal conditions, candidiasis symptoms do not appear.
The development of this disease is explained by a violation of the correct ratio of beneficial and harmful microflora. A similar phenomenon can be observed as a result of a weakening of the immune system, when the number of candida increases several times. In this case, fungi acquire pathogenic properties, become more aggressive and cause the development of inflammatory processes on the mucous membranes and skin.
Today, the Candida fungus is one of the most common infections that are dangerous for both adults and children.
These microorganisms affect almost all organs in the body.disrupting their functioning.
The development of the fungus is indicated by characteristic symptoms, if found, you should immediately seek help from a doctor.
After all, getting rid of it in the early stages is much easier than when Candida spores infect neighboring tissues and organs, and also penetrate deeper layers.
The therapy is carried out with various medications and folk remedies, but you should not self-medicate in order to avoid all kinds of complications.
What is Candida fungus?
Sandida is a genus of fungal yeast.
These microorganisms live in every person, however, when exposed to internal or external factors, they begin to actively multiply, penetrating deep tissues.
The most common are:
- Candida Robusta.
- Candida Stellatoidea.
- Сandida Аlbicans.
Forms and stages
Candidiasis can take several forms and stages:
- smooth skin;
- skin folds;
- chronic;
- generalized;
- oral cavity;
- corners of the mouth;
- urogenital;
- candidal cheilitis;
- candidal paronychia;
- candidal onychia.
Reasons for the appearance
Common causes of yeast development in the human body:
- A pathogenic microorganism is often affects a person whose immune defense is weakened by prolonged use of antibiotics or other strong medicines.
- Reduced protective properties of the immune system in humanssuffering from diseases of chronic etiology or AIDS.
- Diabetes.
- The disease often develops with impaired metabolism.
- The fungus is dangerous for people who eat a lot of sweets and convenience foods, refusing fresh vegetables and fruits.
- This bacterium infects organs with significant hormonal disruptions during pregnancy, during treatment with hormonal drugs, or when taking oral contraceptives.
- Yeast fungus is often diagnosed in people who wear tight synthetic underwear because they do not allow the body to breathe, creating favorable conditions for the development of this pathology.
- Mycosis can develop as a result of vitamin deficiency or hypovitaminosis.
- The bacterium penetrates much more easily into the exhausted organism.
- Violation of the composition of the normal intestinal microflora.
- Latent infection.
- The presence of various injuries of the skin, as well as mucous membranes.
- Frequent stressful situations.
- A sharp change in climatic conditions.
- Long-term residence in an area with poor ecology.
How is it transmitted?
This yeast-like fungus can be transmitted in several ways:
- when using other people's personal hygiene items;
- through the blood of an infected person through transfusion or contact;
- with close contact with stray animals;
- when eating poorly washed food;
- in pools, baths and saunas.
Symptoms
Symptoms of the development of candidiasis (they can be seen in the photo on the Internet) begin to appear after any shift in the internal balance of the body, after which the fungus begins to multiply at an active rate.
In addition to a general deterioration in well-being, the following phenomena are observed in an infected person:
- Bloating, in which there is increased gas production.
- Defecation disorder.
- Frequent abdominal pain of varying degrees.
- Whitish discharge from the genitals.
- Redness of the skin and mucous membranes.
- Active erosion of the skin on different parts of the body.
- Increased body temperature.
- Deterioration of general well-being.
Attention! Other symptoms of this disease may also appear. They depend on which parts of the body are affected by the infection, at what stage the pathology proceeds, as well as on a number of other features.
In men
Candidiasis in men is manifested in this way:
- the onset of severe itching and burning in the foreskin, as well as the glans penis;
- the surface of the glans penis and foreskin is covered with red spots;
- a white cheesy coating appears on the genitals - the most common symptom;
- intercourse can be painful;
- the process of urination causes pain and discomfort;
- when urinating, a white mass resembling semen is released.
These symptoms should not be neglected by delaying treatment.... After all, timely therapy will quickly get rid of the manifestations of pathology and avoid complications.
Among women
This pathology in women can manifest itself in different symptoms:
- Itching and burning is constantly felt in the vulva area;
- A white curdled substance is secreted from the vagina;
- The labia turns red;
- Severe swelling of the labia;
- Unpleasant discomfort occurs when urinating;
- Painful sensations during intercourse.
Attention! In many cases, thrush is accompanied by herpes, chlamydia, or ureaplasmosis. In this regard, doctors have difficulties in diagnosing candidiasis, as well as an accurate determination of the type of pathogen.
In children
Candidal fungus in young children is accompanied by a number of signs, in the presence of which it is imperative to undergo an examination to confirm mycosis of certain organs.
The characteristic symptoms of this disease:
- body temperature rises;
- the mucous membrane in the mouth is covered with a layer of white curd;
- itching of the skin;
- burning sensation in the genital area;
- the appearance on the body of erosions and acne containing a clear or cloudy liquid.
In addition, there are other signs of candidiasis that cause a general deterioration in the condition of the whole organism and disrupt the functions of organs and systems.
Diagnostics
To effectively cure candidiasis, first of all, it is necessary to diagnose and determine which environment contributes to the development of pathology.
Research includes:
Treatment
It can be quite difficult to get rid of the Candida fungus, which has affected the mucous membranes of organs and skin, because the infection lives in different conditions and can change, become immune to drugs, continue to multiply after a course of therapy.
Treatment for mycosis includes:
- adherence to a special diet;
- taking antifungal and probiotic agents;
- taking essential minerals and vitamins;
- adherence to a healthy lifestyle;
- avoidance of stressful situations.
Medication
Various medications can destroy candidiasis:
Topical medications are no less effective than systemic medications.
Therefore, treatment should be started with complex therapy using local drugs, supplemented with bacterial medicines of competing bacteria, fortifying agents, immunotherapy and physiotherapy.
Local medicines
If the body is covered with sores, erosions, acne and other marks that are a manifestation of the development of mycosis, then doctors recommend local therapy.
After all, if pills affect all internal organs, then creams, ointments, vaginal suppositories and infusions only affect the affected skin, effectively eliminating the manifestations of mycosis.
Local therapy is prescribed for the treatment of nail fungus, skin, head, and vagina.
Attention! Before using any of the topical preparations, you should consult with your doctor who will help you choose the most effective medicines that do not cause side effects.
Diet
With active reproduction, yeast fungi have a toxic effect on the human body, therefore experts advise to follow a dietto help clear the infection and prevent further relapses.
At the same time, it is necessary to take into account the individual characteristics of the affected organism, trying to ensure that each product is suitable for both taste and useful properties.
To begin with, the following foods should be excluded from the daily diet:
The following foods must be present in the diet of a person suffering from candidiasis:
- Freshly squeezed fruit juices.
- Fresh vegetables and fruits with low sugar levels.
- Various greens.
- Purified water.
- Natural products containing healthy probiotics.
Important! Compliance with the principles of dietary nutrition will help restore the beneficial intestinal microflora. In addition, the mold will not receive nutrients that contribute to the growth of the fungus, and this will exclude the recurrence of the development of pathology.
Folk recipes
Various folk remedies also help to get rid of the Candida fungus, which are recommended for use in complex therapy with medicines:
Prevention
A person can prevent the development of the disease by following a few simple rules for prevention:
Candida is a type of yeast that affects almost every part of the body., internal organs and mucous membranes. The disease has many different symptoms that worsen the general well-being of a person and cause complications.
Therefore, it is necessary to pay special attention to preventive measures, as well as to undergo a timely examination by a doctor. Thus, a person will get rid of the already developing mycosis and prevent relapses in the future.
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Subtitles
Etiology
Yeast-like mushrooms of the genus Candida belong to imperfect fungi - deuteromycetes (anaskospore). The most common types among patients are Candida albicans and Candida tropicalis.
Yeast-like mushrooms of the species Candida albicans - unicellular microorganisms of oval or round shape. They form pseudomycelium (filaments of elongated cells), blastospores (kidney cells sitting on the constrictions of pseudomycelium) and some chlamydospores - spores with a double shell. The main features that distinguish Candida from true yeast are the following:
- the presence of pseudomycelium
- absence of ascospores (spores in bags inside cells)
- characteristic cultural features
Epidemiology
Most people encounter mushrooms Candida in the first year of life, and according to a number of data in utero. The possibility of infection of the fetus is confirmed by the detection of fungi in the amniotic fluid, placenta, umbilical cord membranes. Further contact of newborns with mushrooms Candida can occur during the passage of the birth canal, with the mucous membrane of the mouth, with the skin of the nipple during feeding, with the skin of the hands during care, as well as with food or household items. A significant contamination of raw meat, dairy products, as well as vegetables and fruits with these mushrooms was revealed. The source, in addition to carriers, may be young domestic animals (calves, puppies, foals), as well as poultry.
The manifestation of candidiasis is mentioned as a frequent side effect that occurs with the use of powerful broad-spectrum antibiotics that are active against many gram-positive and gram-negative microorganisms.
Pathogenesis
The factors of pathogenicity in fungi of the genus Candida include the secretion of proteolytic enzymes and hemolysins, dermatonecrotic activity and adhesiveness (the ability to attach to epithelial cells). All activation of virulence in opportunistic fungi of the genus Candida can be divided into three groups:
- Exogenous factors contributing to the penetration of fungi into the body (temperature conditions, humidity, occupational hazards)
- Endogenous factors causing a decrease in the resistance of the macroorganism (endocrine disorders, metabolic diseases, the use of hormonal contraceptives, courses of treatment with corticosteroid hormones, cytostatic drugs)
- Virulent properties that ensure the pathogenicity of the pathogen.
Clinical picture
The manifestations of candidiasis depend on the localization of the process.
There is a division into superficial and systemic (visceral) candidiasis.
Superficial candidiasis
Superficial candidiasis include lesions of smooth skin, mucous membranes, candidal onychia, and paronychia.
Yeast paronychia and onychia
Paronychia is characterized by edema, infiltration, hyperemia of the nail ridges, and the absence of the supraungual skin (eponychium). At the same time, the periungual roller moves somewhat towards the surface of the nail. Paronychia and onychia often exist at the same time.
Candidamikida
Candidamikids are secondary allergic rashes, indicating a significant degree of sensitization to the pathogen and its metabolic products. They are polymorphic, usually in the form of erythematous-squamous edematous spots, but urticaria and bullous eruptions are also possible. The appearance of candidamikides is accompanied by subfebrile condition, an increase in the main inflammatory phenomena in the main foci.
Oral mucosa candidiasis (thrush)
This form is more common in newborns (but can be at any age). The mucous membrane of the cheeks, as well as the tongue and pharynx, are covered with a whitish coating that resembles flakes of snow (they are also compared to cottage cheese, that is, the mucous membrane looks like a child has just eaten cottage cheese or drank kefir). If the mother had similar manifestations in the vagina during pregnancy or before her, or if she experienced discomfort (itching) in the genital area (vaginal candidiasis), you can be sure that this is candidiasis. In most cases, oral candidiasis does not pose a danger, provided timely and correct treatment. And only if the use of local funds does not have an effect, it is necessary to seriously address the question of the nature of this process.
Intestinal candidiasis
Intestinal candidiasis is one of the varieties of severe dysbiosis. In situations where conditions are created in the intestines that are unsuitable for the life of normal microbes, candida multiply in it. This is manifested by diarrhea, excessive gas formation in the intestines, there is an admixture of white flakes in the stool. For young children, this form of candidiasis is dangerous because they begin to lag behind in weight and height, lose vitamins and other nutrients necessary for normal growth and development with diarrhea.
Candidal vulvovaginitis, balanitis and balanoposthitis
With candidiasis of the genital organs, there are abundant white cheesy discharge, itching is characteristic. For vaginal candidiasis, as well as for other forms, an imbalance of the normal microflora that lives on the mucous membrane is characteristic. When treating vaginal candidiasis, it should be borne in mind that, as a rule, it is necessary to treat the sexual partner, since re-infection with the fungus is possible.
Symptoms of candidiasis in women
Symptoms of candidiasis (thrush) in men
- Burning and itching in the glans and foreskin.
- Redness of the glans penis and foreskin.
- White plaque on the glans penis and foreskin.
- Pain during intercourse.
- Pain when urinating.
- Discharge that is white when urinating, similar to semen
Chronic, generalized (granulomatous) candidiasis
Visceral candidiasis (systemic)
Cases of the spread of combined candidiasis with damage to internal organs and the development of candidal sepsis are recorded in all countries.
Laboratory diagnosis of vaginal candidiasis
A culture study should include not only the isolation and species identification of the causative agent of vaginal candidiasis, but also the determination of the sensitivity of the isolated strains to antifungal drugs. It is advisable to inoculate according to the following scheme: using constantly the standard inoculation technique, rotating the tampon, inoculate the material on a plate with the chromogenic medium "CANDICHROM II"; when viewing the inoculation results, it is necessary to count the number of CFU of various fungi species (quantitative analysis).
The use of the chromogenic selective medium "CANDICHROM II" for primary seeding allows direct identification of the main pathogen Candida albicans and to excrete other types of yeast (bacterial growth is inhibited by a mixture of antibiotics). Other types of fungi of the genus Candida, as well as pathogenic yeast fungi of other genera can be reliably identified to the species level using the Elichrom FUNGI test system.
To determine the sensitivity to common antifungal drugs (fluconazole, itraconazole, amphotericin B, voriconazole, flucytosine (5-fluorocytosine)), it is advisable to use the FUNGIFAST AFG test system. Taking into account the likelihood of the development of secondary resistance to azole drugs in fungi of the genus Candida, it is important to conduct susceptibility testing in isolated strains and before re-prescribing treatment.
Treatment of candidiasis
There are many medications available to treat this condition. Some of them are used topically (cream, vaginal tablets or suppositories), others - inside (tablets or capsules for oral administration). Drugs for the treatment of candidiasis:
From external means of treatment, a 5-10% solution of sodium tetraborate in glycerin topically is also effective. With the defeat of the mucous membranes of the mouth in adults, 20% solution of sodium tetraborate in glycerin topically.
In some cases, treatment is prescribed that complements antifungal drugs (immunotherapy, restorative drugs, physiotherapy, etc.), bacterial drugs of competing microorganisms (lactic acid bacteria, lactobacterin, colibacterin).
Therefore, in order to achieve a complete cure and prevent re-infection, it is necessary to take antifungal drugs not only locally, but also internally. Treatment of patients with chronic forms presents significant difficulties. The ineffectiveness of treatment may be associated with insufficient dosage and duration, as well as with individual insensitivity to one or another group of antifungal drugs. Therefore, it is necessary to carry out bacteriological studies (cultures) with the determination of sensitivity to antifungal drugs. It should be borne in mind that mushrooms have the ability to quickly adapt and form resistance to the drugs used.
In case of recurrent candidiasis (more than 4 exacerbations during the year), a thorough examination for concomitant infections is necessary and the following treatment options are possible in the future:
- Vaginal tablets Neotrizol or Polygynax 1 tab. 1 time per day at night for 8-16 days (especially with the confirmed fact of the presence in the vagina not only of fungi of the genus Candida)
- Vaginal capsules with fenticonazole ("Lomexin") 600 mg - for 1 and 4 days (two capsules).
- Fluconazole (Diflucan, Mikosist, Flucostat) - 150 mg orally for 1, 4, 7 days, then 1 capsule per week for 6 months.
- Correction of conditions provoking the development of candidiasis (diabetes mellitus, immunodeficiency, diseases requiring treatment with hormonal drugs)
Vaginal candidiasis is treated under medical supervision. With a tendency to relapse, especially in the presence of predisposing factors, additional examination and observation by a doctor is necessary.
Prevention of candidiasis
Eating yoghurts containing live lactic acid cultures, as well as natural products with good antifungal effects, such as garlic, propolis, berries and leaves, are good remedies for preventing the growth of fungi.
Candidiasis, better known as "thrush", is a fairly common pathology. The clinical picture is characterized by an abundant white coating on the mucous membranes, lesions of the skin and nails, and discharge from the genitals. Some people mistakenly believe that candidiasis in women or men is a sexually transmitted disease. In fact, this is not so: the symptoms of diseases have some similarities, but they are completely different in etiology. Why does candidiasis appear, how to protect yourself from an unpleasant disease and what are the features of treatment, we will find out together.
Candidiasis, regardless of its location, is an infection caused by an opportunistic fungus of the genus Candida. Microorganisms of candida are present in small quantities in the microflora of the intestines, vagina, and oral cavity. And this is considered the norm. The symptomatology of candidiasis in women and men, as well as newborns, manifests itself when microbes under the influence of certain factors begin to multiply uncontrollably, or more pathogenic strains of the fungus enter the body from the outside. The reasons for virulence (reproduction) of opportunistic fungi are divided into exogenous, endogenous and virulent. It is worth noting that in the world around us, Candida spores are found in water, air, and food.
Candidiasis in women appears under the influence of exogenous factors. These are unfavorable environmental conditions:
- Temperature and humidity conditions conducive to profuse perspiration.
- Frequent or persistent chemical exposure to the skin due to contact with alkali, solvent, acids.
- Mechanical effect on the skin and mucous membranes, injury.
- Increased concentration of spores of yeast-like microorganisms in the air (typical for confectionery, fish processing and meat processing workshops).
- Poor personal hygiene.
Endogenous factors, acting depressingly on the body's resistance, occupy the lion's share in the pathogenesis of the disease. First of all, these are metabolic disorders provoked by severe forms of diseases. So, candidiasis is often diagnosed in women with diabetes mellitus, obesity, chronic dysbiosis, various infectious processes and inflammations, thyrotoxicosis. Severe systemic candidiasis occurs against the background of dysbiosis, which develops after taking broad-spectrum antibiotics, hormonal drugs, and corticosteroids.
In newborns, candidiasis develops against a background of decreased immunity, insufficiency of salivation, and frequent regurgitation. The last two factors are key: they contribute to the disruption of the microflora in the oral cavity and the pathological reproduction of fungi. Newborn babies can experience candidiasis in the first hours of life. Infection occurs in utero, during labor or breastfeeding. Microorganisms are transmitted to the child from the mother, who is the carrier, through instruments, hands or care items (if the medical staff does not follow the rules of hygiene).
Not the least role in the onset and recurrence of candidiasis is played by the properties of the pathogen strain. This is its activity, the volume of enzymes produced, the ability to attach to other cells.
There are three types of candidiasis: superficial, visceral and intermediate, called granulomatous. A separate group includes allergic rashes - candidamikids. Each group has its own localization and manifestation.
- Superficial candidiasis diagnosed in women affect the epithelium and mucous membranes. At the initial stage, they are localized in large skin folds. The site of the lesion swells, becomes swollen, and then undergoes erosion. The affected areas have clear contours, and their edges are scaly and slightly peeling. Erosions with a smooth, shiny surface and a partial whitish bloom multiply, but do not merge with each other. If untreated, their area increases, going far beyond the skin folds, affecting even skin.
- Candidiasis, which affects the mucous membranes of the genitals and oral cavity, is accompanied by a thick, whitish coating that is easily removed. Erosion of various depths is visualized under it. With extensive damage to the oral cavity (tongue, palate, throat, cheeks), candidiasis can go beyond the organ and be visualized on the lips and in their corners. These areas become inflamed, redden, wet. They are called candida seizures, or cheilitis.
- On the hands and feet, candidiasis manifests itself in the form of interdigital yeast erosions, paronychia and onychia affecting the nail folds.
- Vaginal candidiasis affects the reproductive organs. For females - lips, vagina, for males - head, urethra. In most cases, the pathology is complemented by balanitis, vulvitis, vulvovaginitis, urethritis, balanoposthitis.
- People who are prone to allergies to Candida waste products also have allergic rashes. They look like microvesicles and edematous foci. The general condition can be supplemented by malaise, nausea.
Granulomatous candidiasis as a complication
In the absence of treatment or prolonged use of antibiotics, immunosuppressants and corticosteroid hormones, candidiasis turns into a granulomatous form, which is characterized by the following symptoms:
- Extensive lesion with granulating plaques (body, face, scalp).
- Loose growths at the corners of the mouth.
- Infiltrated areas with scaly edges.
Often staphylococcal infection joins, as evidenced by lumpy growths on the skin and mucous membranes with purulent discharge. This stage of the disease is difficult. Patients complain of anemia, pain in joints and bones, chronic cough, dyspeptic disorders. After healing, scars remain on the skin.
Candidiasis in women
In view of the physiological characteristics of the body, vaginal thrush is more common in females. The disease is characterized by a violation of the composition of the vaginal microflora with the subsequent predominance of the fungus on the mucous membrane.
A woman can recognize a disease on her own by the following symptoms:
- Redness and swelling of the labia majora and labia minora.
- Profuse cheesy discharge, complemented by an unpleasant odor.
- Painful sensations during urination, sexual intercourse.
- Excessive dryness of the vaginal opening, which provokes burning and itching, aggravated by mechanical irritation.
Before starting to treat candidiasis in a woman, it is necessary to examine both partners and establish the cause of the pathology.
Features of male candidiasis
Men suffer from candidiasis much less often. The main symptoms that indicate a disease are called:
- Redness and swelling of the head and foreskin.
- White, easily removable plaque in this area.
- Admixture of white flocculent discharge in urine.
- Difficulty and painful urination.
- Burning, itching.
Diagnostics
Before treating candidiasis, a diagnosis is necessary, aimed at determining the strains of the fungus and its sensitivity to antifungal drugs.
- Visual diagnostic methods - examination, including gynecological and urological examination, the study of plaque and formations on the skin and mucous membranes.
- Laboratory diagnostic methods are the gold standard for effective treatment of the disease. Culture research is aimed at identifying strains.
- Differential diagnosis allows you to exclude diseases with similar symptoms, including STDs.
All drugs used to treat thrush are divided into antifungal, antimicrobial, immunomodulatory and combined. Since the candida fungus mainly lives in the intestinal microflora, it is necessary to act on it not with local, but with combined means.
How to treat primary candidiasis? If the case of thrush is a single one, the doctor prescribes local drugs - vaginal suppositories, tablets and ointments containing isoconazole, natamycin, miconazole, clotrimazole. These drugs restore microflora and relieve symptoms (swelling, dryness). Local treatment is supplemented with drugs to increase immunity. In this case, alternative medicine is also effective: teas, decoctions and infusions to increase immunity.
How to treat chronic candidiasis? In case of relapses, systemic treatment is required. Here, drugs are prescribed that act from the inside: capsules, tablets, injections that affect immunity and microflora throughout the body. The course of treatment must include douching and vitamin and mineral complexes.
Prevention of thrush
Live lactic acid cultures (yoghurts, starter cultures), products with antimicrobial properties - affordable and effective prevention of candidiasis. It is recommended to use grapefruit and lemons, propolis, garlic, raspberries and blackberries, lingonberries.
It is important to monitor your weight, limit the consumption of fast carbohydrates (sugar, sweets), yeast baked goods. Not the last place in the fight and prevention of illness is taken by personal hygiene and the culture of sexual relations.