Candidiasis

Candidiasis (candidiasis, thrush) - a group of diseases caused by yeast fungi of the genus Candida. Candida species detected on fruits, vegetables, milk products, waste water baths and so on. E., They are also frequent inhabitants (saprophytes) oral mucous membranes of the digestive tract, respiratory tract, vagina, skin of healthy people. Exogenous transmission fungi contact occurs, possibly through airborne droplets, by eating foods containing yeast-like fungi. The emergence of candidiasis contribute to violations of the body's defenses (severe debilitating disease, cancer, diabetes, beriberi, and so on. D.), As well as long-term uncontrolled use of broad-spectrum antibiotics that suppress the normal flora of the mucous membranes and skin, antagonstov of Candida. There are skin candidiasis (see chap. Skin and venereal disease), isolated candidiasis internal organs, digestive system, lungs, urinary tract, vagina, candida sepsis.

Candidiasis digestive system is most often seen lesions of the mucous membranes of the mouth, pharynx; characterized by the appearance of small red spots, white point later attacks the mucous membrane of the tongue, cheeks, throat, which may coalesce, forming a well-defined lesions covered with milky-white films, which are detected by removing eroded surface. At the same time patients notice a burning sensation in the mouth, sore mucous, difficulty (because of pain), chewing and swallowing. The defeat of the esophagus often localized in its middle third, characterized by edema and hyperemia of its mucosa, ulceration, covered with a whitish film, painful dysphagia. Candidiasis of the stomach and intestine is rare and occurs in the form of catarrhal and erosive gastritis, enteritis, enterocolitis. Severe ulcerative candidiasis gastrointestinal tract may be complicated by gastrointestinal bleeding, perforation and peritonitis.

Candida sepsis is a generalized form of candidiasis is characterized by severe general condition of the patient, hectic fever, the formation of abscesses in various organs (kidney, liver, pancreas, brain, muscle, and TD), often accompanied by purulent meningitis, warty-ulcerative endocarditis. Forecast in many cases unfavorable.

The diagnosis of lesions of the digestive tract kandidamikoznogo establish the presence of characteristic lesions of the oral mucosa with thrush in conjunction with the symptoms of other organs of the digestive system. Determine the esophagus, stomach, colon, you can at endoscopy (while taking discharge ulceration, film laboratory research; make a biopsy of the affected people). Authentic is diagnozkandidoza by laboratory isolation of yeasts (investigated discharge ulcerative lesions of the mucous membranes, pus, bile, with Candida sepsis - blood), as well as the detection of fungi in tissue specimens obtained by targeted biopsy. Have diagnostic value of positive reactions to the vaccine Candida fungi in test serum dilution of 1: 200 or higher and a polysaccharide antigen in the complement-fixation (at 1:20 dilution of serum or higher).

inpatient treatment. Assign by Nystatin 400,000 ED4 times a day (in generalized Candida sepsis daily dose is increased to 4000 000 to 6 000 000 units). When candidiasis rectal suppositories with NIST-Tin (containing 250 000-500 000 units nystatin). Levorin used as an aqueous slurry (1: 200) and rinse buccal tablets 500 at 000 IU oral candidiasis. When candidiasis gastrointestinal Levorinum appointed interior, 500 000 units in the form of tablets or capsules 2-4 times a day. The active antibiotics for candidiasis are amphotericin B and Amphoglucaminum. In stubborn cases, along with antibiotic therapy are treated with a polyvalent vaccine from cultures of Candida, antihistamines, sodium iodide or potassium inside, vitamins of group B. In allergic reactions glucocorticosteroid hormones. It is necessary to treat the disease, against which there is sometimes candidiasis (diabetes, etc.).

Prevention. Eliminating the possibility of infection from patients with candidiasis; sanitary and technical control, mechanization and automation of labor and means of personal hygiene and prevention in enterprises where possible professional candidiasis. Close medical monitoring of patients undergoing treatment of broad-spectrum antibiotics; parallel assignment of B vitamins, if possible - periodic replacement of antibiotics; long-term treatment - prophylactic nystatin ililevorina.