Candidiasis - Causes, symptoms and treatment. MF.
Candidiasis - a disease of the mucous membranes, skin, internal organs, caused by yeast-like fungi Candida( Candida).The genus Candida has more than 170 varieties. Fungi of this genus can be found almost everywhere: from soil, vegetables and fruits to household items and their own organisms, where fungi are an integral part of normal microflora.
Causes of Candidiasis
Candida fungi are single-celled plant microorganisms of oval or round shape( in the photo on the left Candida albicans under the microscope ).The structure of the cell wall provides the fungus with good protection against the effects of unfavorable environmental factors, including drugs. Despite the fact that the optimal temperature for growth is 20-27 ° C, the fungi feel good and at a human body temperature of 37 ° C.Well assimilating sugars, Candida prefer tissues rich in glucose and its containing compounds, which is why candidiasis often develops in patients with diabetes mellitus. The most frequent causative agent of candidiasis are fungi of the species Candida albicans( Candida albicans).To conditionally-pathogenic Candida caused damage to organs and tissues, the organism must be affected by factors that sharply reduce the effectiveness of its protective mechanisms: severe infections, diabetes mellitus, immunodeficiency states, malignant neoplasms, treatment with hormones, corticosteroids, modern antibiotics. Children and the elderly, pregnancy - a state with a higher likelihood of candidiasis.
The source of infection with candidiasis, as a rule, is the body's own flora( autoinfection), however, infection from outside can occur. Causing the disease, the fungus does not change its properties - its properties change the body( local defense decreases).Attaching to the cells of the epithelium, the pathogenic fungus begins to parasitize in them, penetrating deep into the tissues. The penetration depth can be different from the surface epithelial cells in the oral cavity to the entire thickness of the mucosa. In the struggle of the organism with candidiasis, a dynamic equilibrium often arises, when the fungus tends to penetrate deeper into the tissue, but can not, and the body tries to tear it away and also can not. In this case, the process can last for years, shifting the balance in either direction will lead either to recovery or to an aggravation of the process.
Symptoms of Candidiasis
Candidiasis can occur in the form of candidiasis of smooth skin and its appendages, candidiasis of the oral mucosa, urogenital candidiasis, visceral candidiasis, chronic generalized candidiasis.
With candidiasis of skin and its adnexa most often the foci are located in large folds: inguinal-femoral, interannual, axillary hollows, under the mammary glands( skin candidiasis in the photo on the right ).The skin in the interdigital folds can be affected, more often in children and adults suffering from severe diseases - on the skin of the palms, feet, smooth skin of the trunk and extremities. Foci in large folds look like small 1-2 mm vesicles, which are soon opened with the formation of erosion. Erosions increase in size, merge, forming large areas of damage. Foci of candidiasis have an irregular shape, dark red color, around the focus - a strip of exfoliating epidermis. Outside the folds foci have the appearance of red spots with peeling in the center, occasionally small bubbles may appear around the focus.
In interdigital folds of brushes, foci of candidiasis most often appear in people who have a prolonged contact with water( Candidiasis of interdigital spaces in the photo on the left ).Foci occur more often on the hands between 3-4 and 4-5 fingers, there are itching, burning, cracks, foci of dark-red erosion. On the palms and feet, candidiasis looks like the centers of peeling, exfoliation of the epidermis or as foci of excessive keratinization with furrows having a dirty brown color. The defeat of nails in candidiasis consists of the defeat of the okolonogtevogo roller: there is swelling, redness around the nail, the roller becomes thickened, the skin becomes thinner, flakes off. The defeat of the nail is due to the disruption of its nourishment due to the defeat of the okolonogtevogo roller: the nails become thinner, separate from the bed( they look like they are tonsured from the sides), they acquire a yellow-brown color.
Among all localizations of candidiasis in the gastrointestinal tract, candidiasis of the oral mucosa takes the first place. Hippocrates also mentioned it in his works. Candidiasis often occurs in newborns, people who use dentures. Because of the typical symptom - white curdled raids in the oral cavity, this form of candidiasis is called "thrush".At the beginning of the disease, small foci of redness and swelling of the mucous cheeks, gums, and tongue appear as stomatitis. The foci can merge, forming zones of extensive damage. Soon, against the background of these foci appear white cheesy coatings: first small - 1-3 mm increase, merge, forming a film of various shapes and sizes. Films are easily removed, exposing a smooth, shiny saturated red surface. Increases in temperature, inflammation of the lymph nodes with candidiasis of the oral cavity does not happen. In chronic stomatitis, the raids become coarse, more closely adherent to the affected mucous membrane, after removal, erosion remains under them. The tongue grows in size, covered with deep furrows, at the bottom of which you can see a yellow-white coating. Candidiasis of the corners of the mouth or candidiasis congestion usually occurs as a result of the spread of the process from the oral cavity, has the form of erosion or a crack of greyish-white color with clear boundaries. Candidiasis of the lips is manifested by cyanosis of the red border of the lips, peeling in the form of grayish plates. The skin of the lips becomes thinner, gathering in creases.
Candidiasis of the stomach , as a form of visceral candidiasis, develops against the background of peptic ulcer, the decreased acidity of gastric juice can contribute to the development of the fungus. The colony of the fungus, settling in places of ulcerative or erosive damage, slows down their healing, causes pain and bleeding.
In the photo on the left Candida albikans on the mucosa .
Candidiasis of the intestine often occurs after long-term treatment with modern antibiotics and is manifested by discomfort, bloating, diarrhea. The diagnosis of this condition can be established only after studying the composition of the intestinal flora.
Candidiasis of the genitourinary system( urogenital candidiasis) manifests itself most often in the form of vulvovaginitis( also "thrush") in women and balanitis in combination with urethritis in men. Candida vulvovaginitis is called "the disease of our civilization", because many of its achievements, it turns out, create favorable conditions for the development of fungi. These include: synthetic underwear, gaskets, causing an increase in humidity and temperature, which in turn contributes to a change in the structure of the upper layers of the skin.
With vulvovaginitis, against a background of burning and itching, curdled discharge from the genital tract appears, foci of redness with whitish spots appear in the vagina and its vestibule, bubbles may appear around the outbreaks. Itching intensifies in the second half of the day and during sleep, after water procedures and long walking, during menstruation.
When balanitis, the glans penis becomes red, erosion occurs with a whitish coating, itching.
Chronic generalized candidiasis develops in childhood, is associated with a lack of all levels of immune protection, a violation of the thyroid gland, the presence of diabetes. Typically, the process begins with a lesion of the oral mucosa, then foci of candidiasis appear on the lips, scalp, genitals, skin, nails. Such foci with edema, redness, and scaling resemble foci of psoriasis or pyoderma. Internal organs can be affected: there is a candidiasis of the lungs, damage to the eyes, kidneys of the heart. As an extreme degree there is a candidate sepsis, in which fungi from the primary focus are carried by the current of the blood to the organs, causing their defeat. Fungal sepsis often ends in a fatal outcome.
Diagnosis of Candidiasis
The diagnosis of candidiasis is based on the characteristic symptoms of the disease. To clarify the type of pathogen, bacteriological studies are carried out with the sowing of material from the sick person to nutrient media. The detection of a large number of candida fungi in the material from the patient makes it possible to establish the correct diagnosis. Blood tests can be conducted for the presence of antibodies to the cells of the fungus, the fungal cause of the disease will be indicated by the presence in the blood of a large number of antibodies( 1: 160, 1: 320 or more).To study the state of immunity, studies of the level of immunoglobulins A and M, which prevent the attachment of fungi to the mucous membranes, can be carried out.
When diagnosing candidal stomatitis, it must be distinguished from stomatitis of another origin( for example, toxic), fibrinous raids may be mistakenly recognized as fungal colonies. Erroneous diagnoses can be made in the case of leukoplakia( areas of dystrophic changes in the mucous membrane, similar to whitish spots and bands), manifestations of secondary syphilis on the oral mucosa. If necessary, distinguish candidiasis from diphtheria take into account the absence of candidiasis intoxication, inflammation of the lymph nodes, edema of soft tissues. Candidiasis of the lungs can be confused with tuberculosis or neoplasms of the lungs.
Often unrecognized intestinal candidiasis, like another chronic infection( eg, dysentery) continues to be treated with antibiotics, which leads to a worsening of the patient's condition.
Treatment of Candidiasis
Usually, in mild cases of candidiasis, you can do without seeking a doctor, using external means and methods of traditional medicine. However, you should not postpone treatment to a doctor in case of spread of foci of candidiasis, their appearance in new places, fever, inflammation of the lymph nodes. The emergence of foci of candidiasis, not associated with the previous use of antibiotics, should alert not only the patient, but also the doctor: in such cases it is necessary to conduct a survey in order to identify the disease that caused the candidate infection. Referring to a doctor does not need to be postponed if there is even a slight doubt about the signs of the type of infection and the effect of self-treatment.
Treatment of candidiasis, although it aims to completely remove Candida from the source, does not lead to complete release from the body, and in fact is aimed at suppressing the excessive development of fungi. For these purposes, there are special antifungal drugs( antimycotics).Antimycotics are divided into several groups: triazoles( fluconazole, itraconazole), imidazoles( ketoconazole, econazole, clotrimazole, oxyconazole, thioconazole), polyenes( nystatin, levorin, amphotericin B), allylamines( terbinafine, lamizil), echinocandins( caspofungin).
Antifungal agents for mild forms of candidiasis are used mainly in the form of ointments( cannison, nizoral, mifungar), solutions( aniline dyes, iodine), suppository suppositories( pimafucin, gyno-travogen).These funds are used 1 to 2 times a day. If the local treatment does not give the desired effect - use funds with a systemic action in the form of tablets, injections.
With fortifying purpose prescribe vitamins B2, B6, nicotinic and ascorbic acid. The diet should be rich in proteins with a restriction of carbohydrate food, except for sweets. After carrying out studies of the immune status, the function of endocrine glands( endocrine status), the composition of the intestinal flora, their correction or treatment of the identified diseases is necessary.
Treatment of candidiasis with folk remedies
Folk methods of treatment of candidiasis include the use of herbs that have anti-inflammatory, astringent effect( oak bark, chamomile, celandine, bird cherry, marigold, St. John's wort).Decoctions of these plants are taken orally, used for rinses, lotions. Widely used products with medicinal properties: curdled milk, tea mushroom infusion, kvass, dishes with garlic. These products contain not only phytoncides, nutrients and vitamins, but also acids that suppress the development of fungi. As a remedy for the recovery of epithelial tissue, folk medicine recommends carrot juice, both inside and in the form of rinses and lotions. As a sweetener product, licorice and stevia can be used instead of sugar.
Prophylaxis of Candidiasis
Prevention of candidiasis is the timely prevention of it in people at risk: past long-term treatment with antibiotics, immunosuppressants, hormones, immunodeficiency states. Such persons should be examined and when antifungal agents are detected, the timing of fungal infection should be prescribed. When treating candidiasis of the genitourinary system, treatment of the sexual partners of the patient is necessary. Treatment with antibiotics for various diseases should be reasonable, it is strongly recommended not to use antibiotics as self-medication, without the advice of a doctor. Hardening, exercise strengthen the body, increase resistance to any type of infection. At the phenomena of dysbiosis( dysbacteriosis) of the intestine, a diet including sour-milk products with lacto- and bifidobacteria, fermented vegetables, cereal cereals with shell elements, as well as medicines that contribute to the restoration of the normal composition of the microflora is necessary. It should avoid using soap and toothpastes with antibacterial additives. Clothing and underwear should not create a greenhouse effect on the skin. Objects of the surrounding life should be kept clean.
If candidiasis is not treated
Although the symptoms of candidiasis can pass on their own - do not rely on the body's ability and the miracle. Candidiasis needs to be treated. The most likely outcome of untreated( poorly treated) candidiasis is the transition from acute to chronic. In this case, even the dynamic equilibrium mentioned in the article will be a good option. Nevertheless, it is worthwhile to understand that the organism, having surrendered the position once, is likely to continue to cede infection. Fungi will penetrate deep into the affected tissue, causing dystrophic changes in them. Chronic candidiasis with a change in the structure of the affected tissue is much less similar to the known "thrush".This form of the disease is easier to confuse with bacterial infections, lesions of an allergic or autoimmune nature. Penetrated deeply into the tissue, the fungus becomes inaccessible to the action of drugs for external use and even for certain drugs with systemic action. Spreading on the surface, the fungus captures all new areas, passing from mucous to the skin or vice versa. Damaged tissue sites become easily vulnerable to pathogens - there are foci of purulent inflammation.
The deeper the fungus spreads, the closer it becomes to the blood vessels. Once in the blood, candida will be carried by its current through the body, causing the emergence of new foci of candida infection. A destructive effect on the tissue can lead to bleeding. More often it occurs in candidiasis of the gastrointestinal tract. Being foreign to the body, candidas cause the appearance of allergic reactions, taking a perverse, excessive character. Candidiasis during pregnancy can have fatal consequences from infection of the fetus before the termination of pregnancy.
Doctor's consultation on candidiasis
I can not get rid of candidiasis for several years. I've tried almost all the medicines. What to do?
The first: to conduct a full-fledged examination, to identify and treat diseases - the causes of candidiasis, it is possible in the course of the survey to find out that you do not have candidiasis at all.
The second: to conduct a full-fledged treatment. Most patients are undisciplined and take treatment only until the symptoms of the disease that are disturbing them disappear. After the end of treatment - again to conduct a survey.
Does my partner have urogenital candidiasis? What is the probability of contracting it during sexual intercourse?
It is not necessary to consider candidiasis of genital organs as one of venereal diseases. The exchange of candida fungi on contact does not necessarily lead to candidiasis. The likelihood of the disease depends on the degree of decrease in body protection. Nevertheless, in the treatment of candidiasis, one of the partners desires treatment of another partner, regardless of the presence of signs of the disease.
When researching the intestinal flora, I found Candida mushrooms. How to get rid of them?
Fungi candida albikans live in the intestines of most people. The issue is not in stock, but in their quantity. With their excess, correction is necessary, creating conditions( diet, eubiotics, antifungal drugs) that are not suitable for excessive reproduction of fungi.
When should antibiotic therapy be combined with an antifungal drug when treating infections?
Far from always antibiotic treatment leads to the development of candidiasis. When conducting a questioning of the patient, the necessary studies before the appointment of a doctor, the doctor assesses the risk of complications, including the development of candidiasis. In those cases where the likelihood of developing a fungal infection is real or high, together with an antibiotic, an antifungal drug is prescribed. In other cases, the prevention of fungal infections with the help of antimycotics is inexpedient.
Can Candidiasis pass by itself?
Strictly speaking, nothing goes by itself. However, sometimes it is enough to change the way of life( food, occupation, environment, bad habits), so that mild cases of candidiasis pass independently.
Doctor therapist Sokov S.V.