Candidamycosis

Perhaps one of the most well-known fungal diseases is candidiasis, a disease caused by the activity of a yeast-like fungus of the genus Candida, and most often this is the fungus Candida albicans.

This fungus is present in the body of every person, and it is not a pathology.

However, excessive fungal activity that occurs under certain conditions favorable for its development is already a disease that manifests itself in damage to tissues (skin and mucous membranes) or some internal organs.

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Causes of Candidiasis

Candidiasis most often appears under the influence of external factors - due to increased biological activity of fungi, which, for one reason or another, pass from a dormant (saprophytic) state to a pathogenic (disease-causing) state.

The development of candidiasis and the symptoms corresponding to the disease can be facilitated by long-term use of antibiotics (especially strong drugs with a wide range of effects), cytostatics and some other drugs that can provoke a violation of the microflora in the body and cause a secondary deficiency of immunity. In this case, disorders of cellular immune protection play a major role.

There are many other important factors in the etiology of candidiasis:

• disorder of carbohydrate metabolism in the body;
• vitamin deficiency;
• chronic forms of diseases (pathologies of the digestive system, tuberculosis, oncology, autoimmune diseases).

Any condition that weakens the immune system can play a role in the development of candidiasis. This includes malnutrition, lack of sleep, hypothermia, etc.

Children can become infected from their mother or from other people who care for them.

The development of the disease is facilitated by high humidity (baths, saunas, as well as increased sweating in the warm season), especially against the background of irritation and maceration, or superficial injuries to the skin.

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Symptoms of Candidiasis

Symptoms of candidiasis largely depend on the localization of the fungal infection. Thus, candidiasis of the mucous membrane (oral or nasal cavity, throat, esophagus, vagina) can begin with the formation of small reddened spots on the walls, covered with a light milky film, which has a fungal-epithelial component. Gradually, the spots merge, wide areas of damage appear, and the film becomes dense. Often there is a feeling of dryness in the mouth, difficulty breathing or swallowing food. When the vagina is affected, discharge appears.

Candidiasis of the skin begins in folds - between the fingers, under the mammary glands, between the buttocks, in the groin or abdomen of overweight people. The disease often manifests itself on the feet and palmar surfaces. Hyperemia (redness) occurs on the listed areas of the skin, then small blisters, ulcers, and peeling appear. Patients note the appearance of itching, discomfort in the affected area.

Candidiasis can also affect the respiratory system, digestive tract, urinary and genital areas, blood vessels, heart, etc. When candidiasis affects the above organs, specific symptoms are usually absent. The disease manifests itself according to the type of inflammatory process of a specific organ - this can be bronchitis, gastroenteritis, pneumonia, endocarditis, etc. This type of candidiasis most often appears with incorrect or improperly administered antibiotic therapy: inappropriate dosage, early termination of treatment, uncontrolled use of drugs, etc. situations when the use of drugs allows to suppress the growth of bacteria, while contributing to the development of candidal infection.

Vaginal candidiasis

Candida fungus can live inside the vagina even in a healthy woman: this situation is typical for 5% of cases.

The fungus can enter the vagina from the intestines, due to poor hygiene or casual sexual contact.

The presence of fungus does not always cause the disease. Vaginal candidiasis appears only when the body's defenses are weakened. This can often be observed with hormonal changes, metabolic disorders, frequent cystitis and adnexitis.

Long-term use of hormones (contraceptives), disruption of intestinal microflora, and antibiotic therapy contribute to the development of vaginal candidiasis.

Pregnant women are more susceptible to candidiasis: this is due to the drastic hormonal changes in their bodies.

With vaginal candidiasis, patients usually complain of discharge and itching in the genitals. The discharge is often liquid, containing varying amounts of curdled elements. In advanced cases, the discharge may be thick, pasty, with a greenish tint. An unpleasant odor, often sour, may be present.

Itching does not have specific characteristics: it can bother you both periodically and constantly, but it can intensify after prolonged physical exertion or during menstruation.

Often vaginal candidiasis occurs simultaneously with the development of cystitis. In such cases, burning and discomfort are observed during urination.

When examining the vaginal mucosa, you can notice a light gray coating on the walls: the mucosa is edematous, hyperemic (in chronic cases, it may have a normal appearance).

Vaginal candidiasis can last for a long time, even for several years, alternating with periods of remission and exacerbation.

Candidiasis of the oral mucosa

One of the manifestations of fungal diseases can be candidiasis of the oral mucosa, which appears in childhood and adulthood with prolonged dyspepsia and immune system disorders.

Most often, the disease affects newborn babies, but the fungus can also be transmitted to older children if hygiene rules are not followed. The fungus can be transmitted through infected nipples, underwear and care items. Infection of the oral mucosa in a newborn baby can occur from a mother who suffers from vaginal candidiasis. Older children can become ill after long-term therapy with antibiotics, cytostatics or hormones.

The damage to the oral mucosa often begins unnoticed. Only after some time the baby may become capricious, lose appetite and sleep disturbances. Older children and adults may experience a burning sensation in the mouth, many note the appearance of a strange taste in the mouth. Nearby lymph nodes may enlarge. Sometimes hyperthermia appears. If you examine the oral cavity, you can see a whitish coating on the inner surface of the cheeks, tongue or palate. If left untreated, the amount of coating increases, forming a film similar in appearance to cottage cheese or curdled milk. If desired, the film can be easily removed with a spatula, however, in advanced cases, when the coating acquires a gray-yellow tint and becomes denser, this becomes difficult. When forcibly moving the dense coating, reddened mucosa may be exposed, in some cases containing ulcers and bleeding elements of damaged tissue.

Often, candidiasis of the oral mucosa is combined with other forms of candidiasis, when the lesion spreads to the genitals, as well as to other organs and systems. The most common is candidiasis of the corners of the mouth: in this case, the fungal infection affects the lips and corners of the mouth (angular cheilitis).

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Visceral candidiasis

The term "visceral candidiasis" is used to characterize the degree of damage by a fungal infection. The term "visceral" means "relating to internal organs." That is, simply put, any candidiasis of internal organs can be called visceral: lungs, bronchi, heart, digestive system.

Visceral candidiasis does not have any characteristic symptoms. The disease can often be identified only after laboratory tests.

Candidiasis of the stomach may be accompanied by loss of appetite, dyspeptic symptoms (attacks of nausea, vomiting (sometimes with cheesy elements). Indigestion and flatulence are possible.

Candidiasis of the respiratory system is characterized by the appearance of a cough (usually a cough without sputum, dry and paroxysmal), bronchospasm. In advanced cases, purulent discharge from the bronchi appears.

Let us dwell in more detail on the most common manifestations of visceral candidiasis: damage to the esophagus and intestines.

Esophageal candidiasis

Esophageal candidiasis is also called "esophageal" candidiasis - this disease is a consequence of physiological and immunological disorders in the body. As we have already said, one of the reasons for the development of pathology is considered to be the weakness of the immune defense, occurring along with antibiotic therapy, taking corticosteroid hormones, antacid therapy, diabetes mellitus, alcoholism, toxic substance damage, malnutrition, old age. The underlying factor may be a violation of the motor function of the esophagus, obstruction, parenteral nutrition, etc.

Clinical symptoms of the disease may vary. At the onset of the disease, the affected tissue of the esophagus appears as light or cream-colored areas slightly elevated above the mucous membrane. As the process progresses, the areas may merge, forming dense films. In this case, the pathogen penetrates the submucosal layer, then spreading into the muscle tissue and vascular wall. The plaque may grow to such an extent that over time it actually blocks the lumen of the esophageal canal. The fungus, cultivated on the epithelial cells of the esophagus, also retains all kinds of bacteria and inflammatory elements on the surface. In severe cases, an inflammatory process may develop in the esophagus with subsequent necrosis of its walls.

Signs of pathology in the early stages of the disease are mostly absent. However, as the process develops, patients note difficulties with swallowing food, as well as pain when swallowing. In this regard, patients refuse food, lose appetite and, accordingly, body weight.

Some patients do not experience difficulty swallowing, but note the appearance of pain behind the breastbone, heartburn, vomiting attacks with elements of film structures. Sometimes there is loose stool with an admixture of mucus.

The diagnosis is established only if confirmed by laboratory test results.

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Intestinal candidiasis

Intestinal candidiasis can be called a type of complicated dysbacteriosis. The causes of the disease are unchanged:

• states of immune deficiency;
• oncology;
• long-term antibiotic therapy;
• poor nutrition caused by a deficiency of proteins and vitamins, an excess of carbohydrate foods (especially simple carbohydrates);
• alcoholism, metabolic disorders.

The disease is divided into two forms: invasive and non-invasive.

Non-invasive intestinal candidiasis is the most common. The disease is characterized by excessive development of fungal infection on the intestinal walls, which is manifested by a feeling of discomfort, frequent and loose stools, and general weakness of the body. Flatulence and heaviness in the abdomen may be observed.

Invasive candidiasis is a relatively rare disease. This pathology can develop in patients with AIDS, malignant tumors, and in people who have undergone therapy with cytostatic or glucocorticosteroid drugs. The invasive form is accompanied by bloody diarrhea and signs of damage to other organs.

Candidiasis of the intestine is considered separately as a secondary disease after ulcer disease with a violation of the integrity of the epithelial tissue, as well as the perianal form of candidodermatosis, when the skin around the anus is involved in the process. Such a lesion often occurs among homosexuals and occurs against the background of other infections, in particular, herpes.

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Candidiasis of the skin

Candidiasis of skin folds is manifested by the formation of small vesicular formations in their depths, which over time open up on their own, and ulcers appear in their place. The process increases at a relatively rapid pace, the ulcers develop into large areas of erosion.

The symptoms of skin candidiasis are very specific: the areas affected by erosion have a characteristic raspberry hue with a slight blue tint. The outer surface is slightly moist and has a clear varnish shine. The ulcers have clear outlines, limited by a narrow white "fringe" of epidermal layers. On the skin located in close proximity to the erosive area, elements of a rash and small blistering formations can be distinguished.

Often the folds of skin between the fingers become the object of the lesion. This form of the disease is typical for workers in food and processing plants, as well as for people who are actively involved in housework.

Lesions of the skin folds between the buttocks and in the groin area are usually combined with genital candidiasis.

Candidiasis of the skin can occur against the background of nail damage. Often, this disease occurs after visiting public places where people can be barefoot: these are saunas, baths, public showers and swimming pools. Fungus can also be "caught" in a manicure salon if unskilled workers work there who do not handle the instruments properly. Risk factors include using other people's shoes, socks, manicure accessories, towels, etc.

The clinical picture of nail candidiasis is typical: at first the nail thickens and turns pink, and pain appears when palpated. When the disease becomes chronic, the pain disappears, the nail becomes dull and thick with transverse dark grooves.

Recently, cases of atypical forms of skin candidiasis have become more frequent. The disease manifests itself in the development of folliculitis, papillomas, etc.

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Candidiasis in men

Among the male population, the most common symptom of candidiasis is an inflammatory process of the tissues of the head of the penis (balanitis) and the inner part of the foreskin (posthitis). As a rule, these inflammatory processes occur simultaneously. The disease occurs to a greater extent in patients with a narrow and long form of the foreskin, as well as in people who neglect the rules of personal hygiene.

With balanoposthitis, patients complain of itching and burning sensations in the area of the head of the penis. Over time, this area becomes painful. The skin on the head and foreskin is deep pink, swelling may occur. A grayish coating, superficial ulcers and irritations are determined.

Often, against the background of balanoposthitis, men develop candidal urethritis - an inflammatory process in the urethra. The disease is characterized by a subacute onset, but sometimes it is asymptomatic, subsequently complicated by inflammation of the prostate gland, cystitis or epididymitis.

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Diagnosis of candidiasis

When diagnosing candidiasis, a microscopic examination of the material obtained from the affected area, its sowing, intradermal tests with a fungal allergen, as well as serological reactions, including agglutination and complement fixation reactions, are carried out. The material being examined is particles of films, plaque and scales from different areas of the mucous membranes and skin. As a rule, the material is a cluster of fungal cell groups at different stages of development.

Microscopic examinations are used primarily to diagnose candidiasis. They are carried out even in ordinary outpatient settings where specialized laboratories are not available.

For microscopic examination, material is taken from the affected areas using a special spatula or loop. The sample is placed on a treated glass slide and examined. If the result is positive, pseudomycelium or chains of budding cells are detected.

Microscopy is performed several times to determine the positive dynamics of the pathological process. This is usually done at intervals of 4-6 days. If a repeated study reveals a larger amount of the pathogen, this indicates pathological activity of the fungus.

In addition to standard microscopy, a luminescent method is often used, which allows for the identification and recording of the amount of fungal pathogen.

Methods of cultural diagnostics involve the use of solid and liquid carbohydrate nutrient media (agar, beer wort). To obtain pure unmixed fungal cultures, an antibiotic is added to the nutrient medium. In urogenital candidiasis, Candida albicans is most often detected, followed by Candida krusei, Candida tropicalis, and Candida pseudotropicalis or other Candida species, which are extremely rare.

In diagnosing candidiasis, the study of the body's response to fungal infection plays an important role. For example, intradermal allergy tests (introduction of specific antigens) and serological diagnostic methods (agglutination and complement fixation reactions) are used.

When diagnosing candidiasis of internal organs, it is possible to use endoscopy, radiography with contrast agents, etc.

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Treatment of candidiasis

Limited, acute form of superficial candidiasis of skin and mucous membranes is successfully treated by using only external preparations. Chronic forms with diffuse lesions, as well as visceral candidiasis, require the appointment of complex therapy.

To achieve a lasting effect, persistent, multifaceted therapy with antifungal agents is necessary, with the obligatory use of general strengthening drugs to enhance the patient’s immune defenses.

The drugs used in the treatment of candidiasis can be divided into the following groups:

• iodine-containing drugs (sodium and potassium iodide);
• dyes;
• acids (benzoic, salicylic);
• alkalis (sodium bicarbonate, sodium tetraborate);
• aldehydes;
• special antifungal drugs ( clotrimazole - 1 tablet twice a day for 5 days, itraconazole - 200 mg per day for three days, fluconazole or diflucan - 1 time per day, pimafucin - 1 tablet 4 times a day for 10 days).

Local therapy is often used in combination with 150 mg fluconazole.

In chronic candidiasis, which is difficult to treat, nizoral (ketoconazole) is successfully used - a broad-spectrum antifungal drug. For example, in case of urogenital candidiasis, take 2 tablets (0.4 g) orally once a day for 5 days.

If candidiasis occurs against the background of a trichomonas infection, Klion-D is prescribed (contains 0.5 g of metronidazole and 0.15 g of miconazole). The tablet is inserted deep into the vaginal cavity daily for 10 days. Men take Klion-D orally for the same period.

Traditional medicine recommends taking garlic internally to get rid of candidiasis according to the following scheme: eat 1 clove on the first day, then add another clove daily, bringing the amount to 12 cloves. After eating garlic, you cannot eat or drink for about an hour. The recipe is effective, however, it has many contraindications, in particular, gastrointestinal diseases.

In case of oral cavity lesions, it is recommended to rinse the mouth with a decoction of celandine, sage, or a solution of baking soda.

It is also important to follow a diet for thrush.

Prevention of candidiasis

There are a number of preventive measures, the observance of which significantly reduces the frequency of relapses, and also protects against primary infection.

• The first link in the prevention of candidiasis is the restoration of normal microflora of the intestinal and vaginal environment. This can be achieved by consuming fermented milk products and timely treatment of diseases of the digestive system.
• Candidiasis often occurs in patients with a lot of weight, as well as in people who eat high-calorie foods, especially simple sugars, sweets, white and rich pastries. Thus, reviewing your diet and normalizing your weight will significantly reduce the risk of fungal disease.
• If long-term antibiotic therapy is necessary, the possibility of dysbacteriosis and fungal infection should be taken into account and preventive antifungal treatment should be carried out at the same time.
• Patients with immunodeficiency conditions undergo preventive monitoring and all necessary measures to strengthen the body's defenses.
• Patients with diabetes mellitus need to be prescribed effective therapy to lower sugar levels.
• In case of casual sexual intercourse, it is necessary to use external contraception.

Candidiasis prognosis

If the patient consults a doctor at the first symptoms of candidiasis, the prognosis for the disease may be quite favorable.

Self-medication is not recommended, as uncontrolled use of various antifungal drugs, which are freely sold in pharmacies, can lead to the development of persistent fungal infection. Subsequently, this can affect the effectiveness of treatment.

To improve the prognosis, along with treatment, it is recommended to carry out hardening procedures, take vitamin complexes, and observe personal hygiene rules.

Candidiasis is treatable, but the therapeutic approach should be comprehensive, aimed at eliminating the fungal infection and further preventing recurrence of the disease.