Candidamycosis

Perhaps one of the most famous fungal diseases is candidymycosis, a disease that is caused by the vital activity of the yeast-like fungus of the genus Candida, most often Candida albicans fungus.

This fungus is present in the body of every person, and this 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 the defeat of tissues (cutaneous and mucous cover) or some internal organs.

[1], [2], [3], [4],

Causes of candidiasis

Candidamycosis most often appears under the influence of external factors - due to an increase in the biological activity of fungi, which for one reason or another pass from sleeping (saprophytic) to pathogenic (causing disease).

The long-term use of antibiotics (especially strong drugs with a wide range of effects), cytostatics and some other agents that can provoke a disturbance of the microflora in the body and cause a secondary deficit of immunity can contribute to the emergence of candidamycosis and the disease-relevant symptoms. In this case, an important role is played by disorders of cellular immune defense.

In the etiology of candidamycosis there are many other important factors:

• a breakdown in the metabolism of carbohydrates in the body;
• vitamin deficiency;
• chronic forms of diseases (pathology of the digestive system, tuberculosis, oncology, autoimmune diseases).

In the development of candidamycosis, any state in which immunity weakens can play a role. This is malnutrition, lack of sleep, hypothermia, etc.

Children can get infected from their mother or from other people who take care of them.

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

[5], [6], [7], [8], [9], [10]

Symptoms of Candida

Symptoms of candidiasis largely depend on the localization of fungal infection. So, kandidamikoz mucous (oral or nasal cavity, throat, esophagus, vagina) can begin with the formation on the walls of small reddening, covered with light-milk film, which has a fungal-epithelial component. Gradually the spots merge, there are wide damage zones, and the film becomes dense. Often there is a feeling of dryness in the oral cavity, difficulty with breathing or ingestion of food. When the vagina is affected, discharge appears.

Kandidamikoz skin covers its origin in the folds - between the fingers, under the mammary glands, between the buttocks, in the groin or abdomen of fat people. Often the disease manifests itself on the feet and palmar surfaces. On the listed sites of a skin there is a hyperemia (reddening), then there are small blisters, jazvochki, an ecdysis. Patients report the appearance of itching, discomfort in the affected area.

With candidiasis, the respiratory system, the digestive tract, the urinary and genital area, the vessels, the heart, etc., can also be affected. In case of defeat by the candidiasis of the above-mentioned organs, specific symptoms are usually absent. The disease is manifested by the type of inflammatory process of a specific organ - it can be bronchitis, gastroenteritis, pneumonia, endocarditis, etc. This type of candidiasis often occurs when the antibiotic is incorrectly or incorrectly performed: dosage mismatch, early cessation of treatment, uncontrolled drug intake, etc., when the use of drugs can inhibit the growth of bacteria, while contributing to the development of candidal infection.

Vaginal candidiasis

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

Fungus can enter the vagina from the intestine, if hygiene is not respected or if casual sexual contact occurs.

The presence of fungus does not always cause the appearance of the disease. Kandidamikoz vagina appears only when there is a decrease in the protective forces of the body. Often this can be observed with hormonal changes, in disorders of metabolic processes, with frequent cystitis and adnexitis.

A long-term intake of hormones (contraceptives), violation of intestinal microflora, antibiotic therapy promote the appearance of vaginal candidiasis.

Candidomycosis is more likely to affect pregnant women: it is associated with a sharp hormonal restructuring in their body.

When candidiasis of the vagina, the patient usually complains of secretions and itching in the genitals. Discharges are more often liquid, contain different amounts of curdled elements. In neglected cases, the separated can be dense, pasty, with a greenish tinge. Perhaps the presence of an unpleasant odor, more often sourish.

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

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

When examining the mucous membrane of the vagina, you can pay attention to a light gray coating on the walls: the mucous membrane is swollen, hyperemic (in chronic course it can have a normal appearance).

Candidamycosis of the vagina can proceed for a long time, even for several years, followed by periods of remission and exacerbation.

Candidamycosis of the oral mucosa

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

Most often the disease affects newborn babies, but the fungus can be transmitted to older children if the hygiene rules are not respected. Fungus can be transmitted through infected nipples, linen and care products. Infection of the oral mucosa in a newly born baby can occur from a mother who has a vaginal candidiasis. Older children may get sick after prolonged therapy with antibiotics, cytostatics or hormones.

The defeat of the oral mucosa often begins imperceptibly. Only after some time the baby can become capricious, his appetite disappears and sleep is disturbed. The older children and adults have a burning sensation in the mouth, many note the appearance of a strange aftertaste in the mouth. Nearby lymph nodes can be enlarged. Sometimes there is hyperthermia. If you examine the oral cavity, you can see a whitish coating on the inner surface of the cheeks, tongue or palate. In the absence of treatment, the amount of plaque grows, a film is formed that is similar in appearance to cottage cheese, or to coagulated milk. If desired, the film can be easily removed with a spatula, however, in neglected cases, when the plaque acquires a gray-yellow tint and becomes denser, it becomes difficult to do this. With the forcible shift of dense plaque 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 candidiasis of the corners of the mouth: this fungal infection affects the lips and corners of the mouth (seizures).

[11], [12], [13]

Visceral candidiasis

The concept of "visceral candidiasis" is used when characterizing the degree of infection with a fungal infection. The term "visceral" means "referring to internal organs". That is, simply put, visceral can be called any candidiasis of internal organs: lungs, bronchi, heart, digestive system.

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

Candidamycosis of the stomach can be accompanied by a lack of appetite, dyspeptic phenomena (attacks of nausea, vomiting (sometimes with curdled elements) .There is an upset stomach, flatulence.

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

Let us dwell in more detail on the most common manifestations of visceral candidiasis: lesions of the esophagus and intestine.

Candidiasis of the esophagus

Candidamycosis of the esophagus is also called "esophageal" candidiasis - this disease is a consequence of a disorder of physiology and immunology in the body. As we have already said, one of the reasons for the development of pathology is the weakness of the immune defense, taking place along with antibiotic therapy, the intake of corticosteroid hormones, anti-acid therapy, diabetes mellitus, alcoholism, toxic substances, malnutrition, senile 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 be different. At the beginning of the disease, the affected esophagus tissue looks like light or cream areas that slightly rise above the mucosa. With the course of the process, the sections can join, forming dense films. In this case, the pathogen penetrates into the submucosa, then spreads into the muscle tissue and vascular wall. Plaque can expand to such an extent that over time it effectively blocks the lumen of the esophageal canal. Fungi, cultivated on the cells of the epithelium of the esophagus, also restrains all kinds of bacteria and inflammatory elements on the surface. In severe cases, it is possible to develop an inflammatory process in the esophagus followed by necrosis of its walls.

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

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

Diagnosis is established only when confirmed by laboratory test results.

[14], [15], [16], [17], [18], [19]

Candida colon cancer

Kandidamikoz intestines can be called a variety of complicated course of dysbiosis. The causes of the disease are unchanged:

• the state of immune deficiency;
• oncology;
• prolonged antibiotic therapy;
• malnutrition caused by deficiency of proteins and vitamins, excess carbohydrate food (especially simple carbohydrates);
• alcoholism, metabolic disorders.

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

Non-invasive candidamycosis of the intestine is most common. The disease is characterized by excessive development of fungal infection on the walls of the intestine, which is manifested by a feeling of discomfort, frequent and liquid stools, a general weakness of the body. There may be flatulence and heaviness in the abdomen.

Invasive candidamycosis is a relatively rare disease. Such pathology can develop in patients with AIDS, malignant tumors, as well as in people who have been treated with cytostatic or glucocorticosteroid drugs. Invasive form is accompanied by bloody diarrhea and signs of damage to other organs.

Separately, candidamycosis of the intestine is considered as a secondary disease after a peptic ulcer with a violation of the integrity of the epithelial tissue, as well as a perianal form of candidosis when the skin around the anus is involved in the process. This defeat often occurs among homosexuals and occurs against the background of other infections, in particular, herpes.

[20], [21], [22]

Candidiasis of the skin

Kandidamikoz skin folds manifested by the formation in their depth of small pemphigus formations, which eventually open themselves on their own, and in their place appear jazvochki. The process is growing at a relatively rapid rate, the sores grow into large areas of erosion.

The symptoms of skin candidiasis are very specific: the zones affected by erosion have a characteristic raspberry tinge with light blue. The outer surface is slightly moist, has a clear lacquer luster. Ulcers have strict outline, limited by a narrow white "fringe" from the epidermal layers. On the skin, located in close proximity to the erosive site, it is possible to distinguish elements of the rash and small vesicular formations.

Often the skin becomes an object of destruction between the fingers. This form of the disease is typical for workers of food and processing enterprises, as well as for people who are actively engaged in household management.

Defeat of the folds of the skin between the buttocks and in the groin area, as a rule, are combined with candidiasis of the genital organs.

Kandidamikoz skin can occur against the background of nail damage. Often such a disease occurs after visiting public places where people can be barefoot: these are saunas, baths, common showers and pools. Fungus can be "earned" and in the salon of manicure, if there are unskilled workers who unfairly handle tools. Among the risk factors - the use of someone else's shoes, socks, manicure accessories, towels, etc.

The clinical picture of nail candidiasis is typical: at first the nail thickens and turns pink, there is soreness with palpation. When the transition to the chronic form of pain disappears, the nail grows dull and becomes thick with transverse dark furrows.

In recent times, there have been more frequent cases of atypical forms of skin candidiasis. The disease manifests itself in the development of folliculitis, papillomas, etc.

[23], [24], [25]

Candidamycosis in men

Among the male population, the most common symptom of candidiasis is inflammation of the glans penis (balanitis) and internal part of the prepuce (postitis). As a rule, these inflammatory processes occur simultaneously. The disease occurs more often in patients with a narrow and long form of foreskin, as well as in persons neglecting the rules of personal hygiene.

At a balanoposthitis patients complain of sensations of an itch and a burning sensation in a place of a head of a member. Over time, the painfulness of this site also appears. Skin on the head and foreskin is richly pink, it is possible the appearance of puffiness. Defined grayish plaque, superficial sores and irritations.

Often against the background of balanoposthitis in men develops candidiasis 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.

[26], [27],

Diagnosis of candidamycosis

In the diagnosis of candidymycosis microscopic examination of the material obtained from the affected area, its inoculation, intradermal tests with a fungal allergen, as well as serological reactions involving agglutination and complement binding are performed. The investigated material is a particle of films, plaque and scales from different zones of mucous membranes and skin. Typically, the material is an accumulation of groups of fungal cells at different stages of development.

Microscopic studies are used to diagnose candidamycosis in the first place. They are carried out even in usual polyclinic conditions, where there are no specialized laboratories.

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

Microscopy is performed several times to determine the positive dynamics of the pathological process. Usually it is done with an interval of 4-6 days. If a larger number of pathogens were found during the re-examination, this indicates a pathological activity of the fungus.

In addition to standard microscopy, a luminescent method is often used, which makes it possible to identify and keep records of the amount of the fungus pathogen.

Methods of culture diagnostics involve the use of solid and liquid nutrient carbohydrates (agar, beer wort). To obtain pure unmixed fungal cultures, an antibiotic is added to the nutrient medium. With urogenital candidiasis, Candida albicans are most often found, Candida krusei in second place, Candida tropicalis in the third place, and extremely rarely Candida pseudotropicalis or other Candida species .

When diagnosing candidiasis, an important role is played by studying the response of the organism to fungal attack. For example, intradermal allergic tests (introduction of specific antigens) and serological diagnostic methods (agglutination and complement binding tests) are used.

When diagnosing candidiasis of internal organs, endoscopy, radiography with contrast agents, etc. Can be used.

[28], [29], [30], [31], [32], [33], [34], [35]

Treatment of candidamycosis

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

To achieve a lasting effect, a persistent versatile therapy with antifungal agents is necessary, with mandatory use of fortifying drugs to enhance the immune defenses of the patient's body.

The agents used in the treatment of candidamycosis can be divided into the following groups:

• iodine-containing preparations (sodium and potassium iodide);
• dyes;
• acid (benzoic, salicylic);
• alkali (sodium hydrogen carbonate, 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 diflucane - once a day, pimafucin - 1 tablet 4 r./day for 10 days) .

Often, local therapy is used in conjunction with the use of 150 mg fluconazole.

In the chronic course of candidamycosis, which is difficult to treat, successfully use nizoral (ketoconazole) - an antifungal drug of a wide range of effects. For example, with urogenital candidiasis, 2 tablets (0.4 g) are taken orally once a day for 5 days.

If candidamycosis occurs against a trichomonas infection, prescribe Klion-D (contains 0.5 g of metronidazole and 0.15 g of miconazole). The tablet is injected deep into the vagina cavity daily for 10 days. Men consume Clion-D orally for the same period.

Alternative medicine advises to get rid of candidamycosis inwardly using garlic according to the following scheme: on the first day to eat 1 tooth, then add one more tooth daily, bringing the number to 12 teeth. After eating garlic, you can not eat and drink for about an hour. The prescription is effective, however, it has many contraindications, in particular, gastrointestinal diseases.

When the oral cavity is affected, 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 with thrush.

Prophylaxis of candidamycosis

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

• The first link in the prevention of candidamycosis is the restoration of the normal microflora of the intestinal and vaginal fluids. This can be achieved through the use of sour-milk products, timely treatment of digestive system diseases.
• Candidamycosis often occurs in patients with high weight, as well as in people who consume high-calorie food, especially simple sugars, sweets, white and buttery pastries. Thus, a review of nutrition and weight normalization will significantly reduce the risk of fungal disease.
• If long-term antibiotic therapy is necessary, one should take into account the possibility of dysbacteriosis and fungal infection and simultaneously perform preventive antifungal treatment.
• Patients with immunodeficiency states carry out preventive observation and all the necessary measures to strengthen the body's defenses.
• Patients with diabetes should be given effective therapy to reduce the level of sugar.
• In case of accidental sexual intercourse, external contraception should be used.

Prognosis of candidiasis

If the patient turned to the doctor already with the first symptoms of candidamycosis, the prognosis of the disease can be quite favorable.

It is not recommended to use self-medication, as the uncontrolled use of a variety of antifungal drugs that are freely sold in pharmacies can lead to the emergence of a sustained fungal attack. Subsequently, this may affect the effectiveness of treatment.

To improve the prognosis simultaneously with treatment, it is recommended to perform hardening procedures, take vitamin complexes, observe personal hygiene rules.

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