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Candidiasis (thrush)


CANDIDOSIS (Thrush) is a fungal disease of the skin, mucous membranes, nails and internal organs caused by yeast-like fungi of the genus Candida. Its development is promoted by hypoparathyroidism, hypothyroidism, a violation of carbohydrate metabolism associated with pancreatic hypofunction, impaired protein-educational function of the liver, intestinal dysbiosis, which occurs more often with prolonged treatment with antibiotics and corticosteroids. With a decrease in the body's resistance, candidiasis can occur due to injuries of the skin and mucous membranes, maceration of the skin in contact with acids and alkalis, fruit juices, essences, as well as under the influence of a warm and humid climate, adverse working conditions, as a result of violations of the rules of collective and personal hygiene and other

Candidiasis of the oral mucosa (yeast stomatitis, or thrush) often develops in infants and elderly people, especially those weakened by chronic, severe diseases. First, redness and dryness of the oral mucosa appear, then multiple point whitish patches in the sky, tongue, cheeks. When they merge, large, whitish-gray films are formed, which are later easily separated, and surface “dry” erosions are found under them. Whitish areas resembling leukoplakia can also be observed on the mucous membrane.

With candidal vulvitis and vulvovaginitis, itching, burning and slight pain in the external genitalia are noted. Detachable creamy, sometimes on the walls of the vagina and on the external genitalia, tiny patches are found. The disease has a protracted course, especially in patients with diabetes mellitus.

Candidiasis of the skin of the inguinal-femoral and intergluteal folds, axillary fossa, folds under the mammary glands, interdigital folds has the appearance of lesions of red color with a slightly moist surface. On the periphery, foci are surrounded by a border of exfoliating epidermis of a whitish color; often there are small rashes in the form of bubbles, which, when the tires break, form surface erosion, prone to fusion; Often there are cracks in the corners of the mouth (candida jam), the red border of the lips is affected - candida cheilitis, which is characterized by dryness, a feeling of tightening and burning, the appearance of grayish scales.

Candidiasis of paronychia (damage to the nail ridges) and onychia (damage to the nail plates) are common. Nail rollers swell, turn red, with pressure, scanty discharge appears from under them. In the absence of treatment, the nail plates are involved in the process, while the nails are thinned, transverse grooves form on them, their color becomes yellowish-brown.

Candida tonsillitis is characterized by the appearance in the depths of the follicles of the tonsils of white, shiny plugs. The tonsils are hyperemoniric, painless. The body temperature does not increase, there is no soreness when swallowing.

Chronic generalized candidiasis usually occurs in children with immunodeficiency, parathyroid function deficiency. It manifests itself, as a rule, in early childhood in the form of thrush, candida cheilitis. Nail plates, especially the fingers, are often involved in the process at the beginning of the disease. They thicken, as a result of which the nails are deformed, become tuberous, crumble in a number of patients. On the skin, erythematous-squamous, psoriasiform, scarlet-like rashes or foci resembling pyoderma, and sometimes elements of a tubercular-ulcerative nature often appear after resolution of which cicatricial changes remain. Recurrent candidiasis and candidiasis can be observed. Sick children lag behind in physical development. The disease lasts for years.

Candidiasis of the respiratory system is characterized by damage to the larynx, which is accompanied by coughing attacks, a change in the timbre of the voice, the release of mucopurulent sputum, sometimes with an admixture of blood. Candida pneumonia is quite common, occurring as a complication after prolonged treatment with antibiotics. Candidiasis of the lungs is manifested by bronchitis, small focal pneumonia, sometimes caverns are formed.

The diagnosis of typical manifestations of candidiasis of the mucous membranes, skin, periungual ridges, nails, candida sore throat is not complicated. To clarify the diagnosis, a microscopic examination of the pathological material (skin flakes and pieces of nails, separated ulcers, pus, etc.) and obtaining a culture of yeast-like fungi of the genus Candida when sowing material on culture media are necessary. If you suspect a visceral candidiasis, microscopic, cultural, and serological studies are performed.

The treatment is carried out with antifungal agents (nystatin, levorin, nizoral, etc.). Topically applied are aqueous and alcoholic 1-2% solutions of aniline dyes and 1% solution or cream of canesten (clotrimazole). In chronic candidiasis, immunotherapy is also carried out.