Fungal thrush. Thrush: Where does it come from and when to see a doctor. Chronic generalized candidiasis

– fungal disease, predominantly affecting the skin and mucous membranes, less often internal organs. There are candidiasis of respiratory, digestive, genitourinary systems. With a sharp weakening of the immune system, generalized candidiasis (candidal sepsis) can develop. Urogenital candidiasis in men is manifested by inflammation of the penis (redness, swelling, covering with a grayish coating and erosion, itching, burning and pain in the area of the head of the penis). Candidal urethritis and cystitis are possible. In women, damage occurs to the external genitalia and vagina. Without timely treatment, candidiasis takes a chronic, relapsing course.

Urogenital candidiasis is caused by yeast-like fungi of the genus Candida, representatives normal microflora mucous membranes of the genital organs. The development of candidiasis occurs as a result of the intensive proliferation of Candida fungi and their disruption of the natural balance of the environment of the genitourinary tract. The development of candidiasis is greatly facilitated by a general decrease in the body's resistance.

Urogenital candidiasis is not a health or life-threatening disease, but it is extremely unpleasant due to its manifestations, leading to disturbances in the intimate and psycho-emotional spheres. In addition, the presence of candidiasis may indicate severe concomitant pathology ( diabetes mellitus, HIV infection, etc.).

Genital candidiasis, or so-called thrush, affects the mucous membranes of the urogenital tract of men and women, being essentially a sexually transmitted infection. Thrush is often accompanied by other diseases with sexual transmission: chlamydia, gonorrhea, trichomoniasis, etc.

Acute and subacute course of candidiasis lasts no more than 2 months. During this period, swelling, hyperemia, discharge from the genital tract and other inflammatory symptoms are pronounced. Chronic forms of candidiasis are characterized by a duration of over 2 months. Foci of dryness develop on the mucous membranes, hyperpigmentation, infiltration, tissue atrophy.

IN Lately Atypical, erased and treatment-resistant forms of genitourinary candidiasis have become common.

Thrush is an inflammatory lesion of the vaginal mucosa caused by fungi of the genus Candida. It is characterized by burning and itching in the vagina, white cheesy discharge. Thrush is also called neonatal candidiasis, most often manifested as oral candidiasis. Thrush is diagnosed by detecting the fungus through microscopy and culture of vaginal smears. To exclude concomitant STIs, ELISA, RIF and PCR studies are performed. Chronic recurrent thrush is an indication for a complete examination of the patient in order to identify those disorders in the body that could cause such a course of thrush. Treatment is carried out locally and general use antimycotic drugs.

Yeast-like fungi Candida, which provoke the development of thrush, are opportunistic flora of the vagina of most women and do not cause any pathological symptoms. Therefore, unlike classic STIs, thrush cannot be 100% classified as a sexually transmitted disease, although Candida fungi can be transmitted from sexual partners. Clinical gynecology deals with the diagnosis and treatment of candidiasis due to its similarity clinical picture with sexually transmitted infections and frequent cases of a combination of these diseases.

Causes of the disease

The development of thrush is caused by various factors that disrupt the healthy microflora of the vagina. As a result, there is a decrease in the number of beneficial bacteria that normally inhibit the growth of fungal flora, and intensive proliferation of fungi. Active growth of fungi leads to the manifestation of their pathogenic properties with the appearance of inflammatory changes in the vaginal mucosa such as colpitis or vaginitis.

Violation of the normal ratio of microorganisms in the vagina with the development of thrush can be caused by treatment with cytostatics and other immunosuppressants, the use hormonal contraception, decreased immunity due to somatic diseases(HIV, Chronical bronchitis, tonsillitis, chronic pyelonephritis , cirrhosis of the liver, etc.), hormonal abnormalities ( diabetes , ovarian dysfunction, menopause, hypothyroidism, obesity), anorexia, pregnancy, stressful situations, sudden climate change.

Long-term or frequent antibiotic therapy, use antibacterial drugs without additional administration of probiotics primarily cause intestinal dysbiosis. Since the intestines are a reservoir of Candida fungi, its diseases (dysbacteriosis, colitis, etc.) lead to the spread of Candida to other organs and primarily to the vagina with the development of thrush.

Various local factors can have an adverse effect on the vaginal biocenosis with the appearance of thrush: poor personal hygiene, irregular change of pads and vaginal tampons, the use of local contraceptives, the use of deodorized pads and scented colored toilet paper, wearing synthetic underwear. Frequent use of antibacterial products (antibacterial soap, intimate gel, vaginal spray) for hygienic purposes often leads to a decrease in local natural immunity and can provoke the occurrence of thrush.

Some women experience thrush after wearing wet underwear, visiting a pool or swimming in open water. This is due to the beneficial effect of a humid environment on the vital activity of Candida fungi. Poor nutrition Excessive consumption of sweets can also contribute to the development of thrush.

Newborns born to mothers with thrush may develop thrush as a result of infection during the fetal period or passage through the birth canal. The development of thrush in such cases is facilitated by the weakened state of the child’s body due to the birth trauma received. premature birth , hemolytic disease , intrauterine hypoxia, transferred asphyxia of the newborn.

The causes of thrush are various factors:

infectious diseases, as well as sexually transmitted infections: chlamydia, trichomoniasis, mycoplasmosis, ureaplasmosis;
endocrine diseases: diabetes, obesity, etc.;
reception medicines(especially antibiotics);
at hormonal disorders(for example, taking hormonal contraception increases the risk of thrush);
diseases in which immunity is weakened: viral infections, acute respiratory infections, ARVI;
non-compliance intimate hygiene ;
exacerbation is observed in hot weather, when various bacteria and fungi are activated;
sexual contact without barrier contraception;
stress, nervous experiences;
unhealthy diet;
wearing underwear made of synthetic fabrics that is too tight.

This disease can be caused by many different factors. Among them are:

stress;
hypothermia;
hormonal imbalance;
venereal diseases;
infections;
dysfunction of the thyroid gland;
diabetes;
using uncomfortable or synthetic underwear.

Development of genital candidiasis

According to studies conducted in the field of venereology, the following factors most often contribute to the development of genital candidiasis:

taking antibacterial and a number of hormonal medications;
pregnancy;
intestinal candidiasis (dysbacteriosis);
diabetes;
HIV and other infections that suppress the immune system;
excessive douching;
wearing synthetic and tight underwear;
long-term adverse effects physical factors(work in warm, damp rooms, etc.).

Symptoms

Thrush is manifested by severe burning and itching in the area of the external genitalia and vagina. These symptoms are accompanied by the appearance of a white discharge characteristic of candidiasis. Thrush is characterized by a heterogeneous consistency of discharge with small lumps resembling grains of cottage cheese. The discharge may have a sour odor. Many women suffering from thrush note an increase in the amount of discharge after sexual intercourse, water procedures, at night time. Redness of the labia minora is often observed, and sometimes swelling of the labia minora and majora is observed, which can reach the anus. Swelling and inflammatory changes in the vaginal mucosa during thrush lead to pain during sexual intercourse. There may be painful urination.

Quite often there is an erased course of thrush, when it clinical manifestations mild or only one of these symptoms is present. Symptoms of thrush can spontaneously resolve with the appearance of menstrual flow, since during this period the vaginal environment shifts to an alkaline side, less favorable for fungi. However, thrush can also acquire chronic course. Its relapses, as a rule, occur at least 4 times a year and usually occur a week before the start of menstruation. Chronic thrush is much more difficult to treat and can lead to complications. It is possible to combine thrush with other infectious lesions of the vagina (ureaplasmosis, chlamydia, genital herpes and etc.).

The most common manifestation of thrush in newborns is candidiasis of the gums (gingivitis), soft palate, buccal mucosa (stomatitis) and tongue (glossitis). It is manifested by the appearance of areas or spots covered with a white coating on the mucous membrane. When the plaque is removed, the red and inflamed mucous membrane underneath is exposed. A newborn suffering from thrush is restless, often cries, sucks poorly and may refuse to breastfeed. Less commonly, neonatal thrush manifests itself in the form of candidal conjunctivitis. Consequence intrauterine infection Pneumonia caused by fungi may occur.

Taking into account the area affected by the disease, they distinguish the following types candidiasis:

Surface.
Interdigital.
Candidiasis of the mucous membranes.
Yeast paronychia and onychia.
Candidiasis vulvitis and colpitis (vulvovaginal candidiasis).

Surface

This form of the disease is characterized by damage to smooth skin mucous membranes. Skin candidiasis originates from large folds, where the formation of erymatous-punctate foci with vesicles, erosions and pustules occurs. Cutaneous candidiasis involves the presence of affected areas, which are characterized by clear scalloped edges.

The erosion surface has a smooth, shiny appearance, sometimes a whitish coating is found.

Skin candidiasis can be of two types: erythematous and vesicular. The first type is characterized by the presence of foci on the surface of which erosion and weeping predominate. Vesicular type cutaneous candidiasis is characterized by the formation of a large number of serapules, blisters, pustules and vesicles.

Interdigital

This form of yeast infection is most often diagnosed in schoolchildren and adults whose work requires prolonged exposure to garden plots. In this case, you can find foci of maceration between the fingers with edematous-stagnant hyperemic skin.

With this form of the disease, genital candidiasis and yeast-like lesions of the oral cavity develop. Symptoms depend on the location of the lesion. Candidiasis of the oral cavity and mucous membranes is accompanied by the presence of a whitish, cheesy coating, on the surface of which there is a peelable film. When it is removed, erythema may develop. Candidiasis in the mouth can affect:

language;
corners of the mouth;
lips;
tonsils.

Oral candidiasis occupies a leading position in relation to all localizations of this disease in the gastrointestinal tract. Candidal stomatitis very often affects newborns and adults who use dentures.

Due to the presence of white cheesy deposits in the oral cavity, candidal stomatitis is also called “thrush”. Candidal stomatitis on initial stage has the following characteristic symptoms:

small areas of redness;
swelling of the mucous membranes of the gums, cheeks, tongue;
when the lesions merge, white cheesy deposits appear, which increase in size over time;
When the film is removed, the surface becomes smooth, shiny and deep red.

Oral candidiasis does not cause increased body temperature or swollen lymph nodes.

If candidal stomatitis of a chronic form is present, then it is characterized by its own manifestations:

coarse deposits more closely adjacent to the affected mucosa;
after removing the film, erosions form underneath them;
an increase in the size of the tongue, covering its surface with deep grooves.

Oral candidiasis, which affects only the corners of the mouth, is formed due to the spread of yeast bacteria from the affected area. It is characterized by the presence of erosions or cracks of a grayish-white hue with clear boundaries. Candidiasis of the lips has a bluish tint in the area of the red border of the lips, peeling in the form of grayish plates.

If we are talking about a disease such as candidiasis of the tongue, then its symptoms are very similar to those of a fungal infection of the throat. The disease occurs in the form of stomatitis, bleeding wounds and ulcers form on the mucous membrane. After a certain time, white bubbles and films appear at the site of these wounds. Gradually, candidiasis of the tongue spreads and covers an increasingly larger surface.

Gastrointestinal lesions

Gastric candidiasis is a disease that belongs to the type of visceral candidiasis. It is formed by the following reasons: peptic ulcer, low acidity gastric juice.

Intestinal candidiasis is a consequence of prolonged therapy with modern antibiotics. Intestinal candidiasis is accompanied by the following symptoms:

flatulence;
discomfort;
diarrhea.

In addition, intestinal candidiasis can cause pain in the abdomen, and stool blood or mucus is detected in the patient. A person experiences a feeling of incomplete bowel movement. If intestinal candidiasis occurs in severe form, then it is characterized by an invasive phase. A diagnosis of intestinal candidiasis can only be made after the composition of the intestinal flora has been studied.

Esophageal candidiasis is a disease that is very difficult to identify among all those available in the field of gastroenterology. The disease is characterized by a discrepancy between the severity of the disease, the level of damage and the condition of the patient himself. Almost 30% of patients may not even suspect that they have esophageal candidiasis. As a rule, this applies to those people who have low level immunity. However, esophageal candidiasis has the following manifestations:

heartburn;
poor appetite;
disturbances in the process of swallowing food;
painful sensations during swallowing;
chest pain;
frequent vomiting and nausea;
temperature increase;
diarrhea;
pain attacks in the upper abdomen.

There are cases when candidiasis of the esophagus, accompanied by pain when swallowing, does not even allow you to swallow water. This condition can contribute to dehydration. When vomiting occurs, characteristic whitish films can be found in the vomit.

This form of the disease is characterized by itching and a burning sensation of varying intensity. Candida vulvitis occurs in women during the premenstrual period and postmenstrual phase. Vaginal candidiasis is accompanied by intense and moderate inflammation of the mucous membranes of the genital organs; a purple-bluish tint may be present. In addition, vulvitis is characterized by the following symptoms:

small rashes in the form of vesicles, when opened, erosions are formed;
vulvovaginal candidiasis may be accompanied by layers in the form of white cheesy crumbly films;
dryness and lichenification of the labia minora and majora, which have a whitish surface;
the itching that causes candidal colpitis intensifies when urinating, after taking a bath and having sexual intercourse.

Complications of thrush

Chronic thrush can cause a number of complications. Primarily, they are caused by the spread of fungal infection to structures located near the vagina: the cervix with the development of cervicitis, the urethra with the development of urethritis, and the bladder with the development of cystitis. The combination of thrush with other STIs with a long-term recurrent course can lead to the development of infertility in women.

Diagnosis of genital candidiasis

Laser research methods include:

microscopy of a smear of discharge;
cultural diagnostics;
linked immunosorbent assay;
polymerase chain reaction.

When symptoms of candidiasis occur, men usually seek help from a urologist, and women come to consultation with a gynecologist. Diagnosis of genitourinary candidiasis is carried out on the basis of complaints and examination of the mucous membranes of the genital organs. The diagnosis of candidiasis is confirmed by examining the discharge of the vagina or penis using light microscopy, bacterial culture and determining the sensitivity of the isolated varieties of Candida to antifungal drugs.

Consultation with a venereologist is necessary for behavior differential diagnosis candidiasis with trichomoniasis, gonorrhea, gardnerellosis, other urogenital infections and exclusion of concomitant STIs.

In case of genital candidiasis, it is necessary to exclude the presence of chronic diseases of the body and assess the state of immunity.

Diagnosis of candidiasis does not require the use of high-precision laboratory techniques, such as PIF or PCR, which detect even single pathogens. Criteria for diagnosing candidiasis genitourinary organs serves to identify the fact of intensive reproduction of fungal pathogens.

As a rule, patients with symptoms of thrush consult a gynecologist. The doctor conducts examination on a chair and colposcopy, takes smears from the mucous membrane of the cervix and vagina. Microscopic examination of smears for thrush reveals the presence of fungal mycelium in the preparation. This quick method research, but it does not provide accurate information about what type of fungi caused the disease. To answer this question, a smear is cultured on special nutrient media, followed by a study of the grown colonies and determination of the susceptibility of the isolated Candida fungi to antimycotic drugs. In this case, the quantitative characteristics of the identified Candida colonies are taken into account, since their small number is normal for a healthy vaginal microflora.

Clinical observations show that thrush quite often occurs against the background of other sexually transmitted infections and can “mask” their presence. Therefore, if thrush is detected, it is advisable to additionally consult a venereologist and undergo testing for STIs. Typically, complex PCR diagnostics are used, which, if necessary, can be supplemented by ELISA and RIF.

Since the development of thrush is usually associated with certain disorders occurring in the body, when identifying it it is necessary full examination women. This is especially true in cases where thrush does not respond well to treatment or takes a chronic course. Thrush is often the first symptom of diabetes. Therefore, a woman needs to take a blood test for sugar and, if an increase is detected, contact an endocrinologist. An examination by a gastroenterologist is also recommended: analysis for dysbacteriosis, coprogram, gastroscopy, radiography of the stomach, Ultrasound abdominal cavity , irrigoscopy, x-ray examination of the small intestine.

With the development of complications of thrush from the urinary tract necessary urologist consultation, examination of urine and urethral smear, Zimnitsky test, ultrasound Bladder. Differential diagnosis of thrush should be made with bacterial vaginosis, gonorrhea, genital herpes, and trichomoniasis.

Generalized form of candidiasis

In particularly unfavorable cases pathological process can affect many organs with the development of a generalized form of candidiasis. Risk factors for the development of generalization of candidiasis are prematurity, the use of glucocorticoids and antibiotics, artificial nutrition, chemotherapy, drug addiction, surgical operations And postoperative period and etc.

Treatment of thrush in pregnant women

Thrush occurs in more than half of pregnant women. Its treatment requires an integrated approach, taking into account the contraindications that exist during pregnancy. It is important to identify diseases and pathological conditions, which can provoke thrush. In pregnant women, thrush is treated mainly with local remedies. Most often these are suppositories with miconazole or clotrimazole. If systemic antifungal therapy is necessary thrush in pregnant women it is possible to use natamycin, since it does not have an embryotoxic effect.

Can be used during pregnancy traditional methods treatment of thrush. These include washing with a decoction of oak bark, calendula or soda solution, soda-iodine baths, etc. These methods are weakly effective in completely curing thrush, but can help relieve its symptoms during pregnancy.

Prevention

The best prevention of thrush is following the rules of personal hygiene.
Regular washing and changing of underwear are required.
It is advisable to use a separate towel for the genitals.
You need to visit a gynecologist regularly (once every six months).
After visiting the pool or swimming in open water, it is advisable to do herbal douching.
Remember to use condoms or other barrier methods of contraception.

Prevention of thrush includes adequate antibiotic therapy along with the mandatory administration of probiotics; timely and correct treatment of chronic diseases, STIs, hormonal disorders; maintaining intimate hygiene; wearing cotton underwear. You should avoid the use of hygiene and intravaginal products that can change the pH of the vagina from the acidic side or cause an imbalance in its microflora. To prevent thrush from developing from improper use of tampons and pads, women should remember that they need to be changed every 3-4 hours. Women whose thrush is caused by a humid environment should dry themselves thoroughly after swimming, avoid wearing a wet swimsuit, and use a spare dry swimsuit when relaxing on a pond.

Prevention of thrush in newborns is facilitated by a complete examination of women when planning pregnancy, early detection and treatment of thrush in pregnant women.

Thrush(candidiasis) is a fungal disease that occurs due to a violation of the vaginal microflora.

Occurrence of disease

The causative agent of the disease is the yeast-like fungi Candida. Moreover, these fungi are present in the body of any person. As soon as a favorable environment for their intensive reproduction appears, the number of mushrooms acceptable for a healthy person increases sharply. This leads to thrush.

The main thing is to detect the symptoms of the disease in time and take measures to prevent them, otherwise the presence of thrush can lead to other gynecological problems. And this happens because the damaged mucous membrane of the genital organs is simply not able to resist other diseases.

Symptoms of thrush

itching, which intensifies as the disease progresses;
discharge. They are white in color and have a consistency similar to sour cream. By the amount of discharge, you can independently understand how advanced the disease is. With prolonged forms of thrush, the discharge is a cheesy mass;
hypersensitivity of the genitals when in contact with urine and even water.

If you notice these symptoms, you should immediately go to the doctor, who will correctly diagnose and prescribe treatment.

Causes of the disease

The causes of thrush are various factors:

infectious diseases, as well as sexually transmitted infections: chlamydia, trichomoniasis, mycoplasmosis, ureaplasmosis;
endocrine diseases: diabetes, obesity, etc.;
taking medications (especially antibiotics);
with hormonal disorders (for example, taking hormonal contraceptives increases the risk of thrush);
diseases in which immunity is reduced: viral infections, acute respiratory infections, acute respiratory viral infections;
failure to maintain intimate hygiene;
exacerbation is observed in hot weather, when various bacteria and fungi are activated;
sexual contact without barrier contraception;
stress, nervous experiences;
unhealthy diet;
wearing underwear made of synthetic fabrics that is too tight.

Treatment

It is best not to delay treatment. If you experience any of the above symptoms, contact your doctor immediately. Today, the pharmacy has a huge selection of drugs (tablets, vaginal suppositories, creams, ointments) that help in the treatment of candidiasis. The most famous of them are “Flucostat”, “Terzhinan”, “Clotrimazole”, etc. Very often, in addition to these drugs, doctors also prescribe Trichopolum. Many people believe that this drug only treats sexually transmitted diseases. But that's not true. There is no need to be intimidated by the name of this medicine. This drug has a broad effect on all types of fungi.

In addition to medications, you may be prescribed herbal douches. As a rule, chamomile, celandine, and oak bark are prescribed - those plants that have anti-inflammatory and astringent effects. Moreover, each herb can be used separately, or mixed. A blend of chamomile and oak bark is considered very effective. Chamomile relieves itching and irritation, and oak bark has an astringent effect. The decoction is made in a water bath. To do this you will need 1 tablespoon of herbal mixture and 200 ml of water. Allow the broth to cool, strain and dilute with water to 400-500 ml. Use the resulting liquid and douche. But you need to leave some of the broth in order to wash the external genitalia later. Before and after douching, it is imperative to rinse the syringe with boiled water, or even boil it.

If you are prescribed suppositories, they are usually placed at night, after douching.

It is better to avoid sex during the treatment period.

The usual course of treatment lasts from 5 to 10 days. The entire course must be completed in full, without interruption. Together with the woman, her sexual partner should also be treated.

Prevention

The best prevention of thrush is following the rules of personal hygiene.
Regular washing and changing of underwear are required.
It is advisable to use a separate towel for the genitals.
You need to visit a gynecologist regularly (once every six months).
After visiting the pool or swimming in open water, it is advisable to do herbal douching.
Remember to use condoms or other barrier methods of contraception.

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The number of diseases caused by fungal infections is constantly growing. The leading position among them is occupied by candidiasis. In everyday life, this disease is better known as “thrush”. The disease is a chronic infectious process that is caused by pathogenic fungal microorganisms of the genus Candida. Fungi affect not only the skin and mucous membranes, but also internal organs, which can lead to serious health consequences.

It is impossible to completely get rid of fungal microorganisms. However, lifestyle changes and the correct treatment tactics, selected by a doctor, will help stop their growth and reduce their number to normal. In this article you will learn everything about candidiasis, its symptoms and treatment.

Why does the disease occur?

In no large quantities yeast-like fungi of the genus Candida are present in the body of any person. However, when immunodeficiency occurs, their active growth begins, the body’s defenses fail, and a disease occurs.

Can lead to decreased immunity various reasons. However, the biggest culprit is inappropriate or inappropriate use of antibiotics. They destroy “good” microorganisms in the intestines, which guard human health. Without them, the defense weakens and the infection takes over.

There are also negative factors that can provoke the disease. They are divided into 2 large groups:

External.

Thanks to them, the infection enters the body through damaged skin (burns, cuts, cracks). For example, damage to the oral mucosa can occur due to poor hygiene, periodontitis, and incorrectly selected dentures.

Internal (endogenous).

These include diseases that lead to decreased immunity, as well as a congenital state of immunodeficiency. These are vitamin deficiency, hormonal imbalances, metabolic disorders, anemia, chronic pathologies Gastrointestinal tract, diabetes mellitus.

Signs of candidiasis may appear due to frequent exposure to the skin or mucous membranes chemical substances. Taking hormonal contraceptives, alcohol abuse, smoking, unfavorable environment in the place of residence and frequent stress can also lead to the disease.

How does candidiasis manifest?

Manifestations of this infectious disease varied. They depend on the place of origin and on which organ was attacked by yeast-like fungi of the genus Candida. Let's look at the main types of the disease and its symptoms.

Superficial candidiasis

It develops on the surface of the skin and its appendages (hair, nails), and also affects the mucous membranes of the lips, mouth, genitals and anal area.

Candidiasis of the oral cavity and larynx

The most common complaint is that a person is bothered by burning, dryness or discomfort in the mouth. The pain gets worse when eating. The oral mucosa becomes swollen, and small white rashes appear. A whitish film or a strong gray coating may form.

Lesions of skin, nails and hair

With cutaneous candidiasis, symptoms at the initial stage appear in the form of a slightly noticeable white stripe in the folds of the skin. Then itching occurs, and erosive lesions occur. Small bubbles merge, and the fungal disease spreads to healthy areas. If a secondary infection occurs as a result of scratching, ulcers occur.

When a fungal infection affects the nails, redness of the nail fold first occurs, and then ulcers may appear. The nail plate itself becomes fragile, may crack, and throbbing pain occurs.

Candida lesion hair follicles does not occur often. This disease manifests itself in the formation of a purulent rash in the area of hair growth on the head or in the area of the beard and mustache.

Candidiasis of the genital organs

In women, opportunistic microorganisms of the genus Candida are constantly present in the vagina, and normally do not manifest themselves in any way. But under the influence of unfavorable factors, their number increases, and then the woman develops candidiasis or thrush.

Typically, burning and itching in the male genital area is felt 2-3 hours after contact. However, after a couple of days, the symptoms weaken or completely disappear until the next sexual intercourse. In severe cases, multiple ulcers occur, which can spread from the genitals to the skin (inguinal folds).

The female form of candidiasis is accompanied by itching, which intensifies during movement, during sexual intercourse and during menstruation. There may be sensations of burning, pain and discomfort. Complaints of thick, cheesy discharge often occur. Externally, you can notice the swollen mucous membrane of the labia with small pinpoint inclusions.

Chronic generalized candidiasis

This form of the disease is characterized by multiple lesions of the skin, mucous membranes and internal organs. It manifests itself externally in the formation of dense white plaque, after removal of which erosions form. It is a fairly rare form of the disease, so the exact causes of its occurrence have been little studied. It manifests itself as general malaise, lethargy, headaches, apathy, and fever.

Systemic candidiasis

Fungal microorganisms infect only internal organs and systems.

Gastrointestinal tract

If the esophagus, stomach or intestines are affected, painful sensations appear when swallowing, a burning sensation, nausea, vomiting, and frequent belching. Due to pain during eating, a person’s appetite decreases and weight decreases, which leads to a deterioration in overall well-being.

Respiratory organs and airways

Fungal microorganisms can enter the larynx, trachea or bronchi from the affected oral cavity. Characterized by cough, difficulty breathing, itching. The disease negatively affects the vocal cords, which can lead to hoarseness or temporary loss of voice.

Genitourinary system

A common cause of candidiasis affecting the genitourinary organs is nosocomial infection. It is also possible that this disease may appear as a complication after surgery. It mainly occurs in the form of diseases such as cystitis, urethritis and pyelonephritis with all the accompanying symptoms.

If adequate treatment is not started in a timely manner, candidiasis infection of any kind becomes chronic.

Diagnostic methods

It is known that there are more than 70 species of yeast-like fungi of the genus Candida. Many of them can lead to painful symptoms, so a preliminary examination is extremely important to determine the correct and effective treatment.

To determine the causative agent of an infectious disease, a series of tests must be carried out. laboratory research. Diagnosis of candidiasis includes the following methods:

study of biological material (skin, mucus, plaque). For this purpose, skin scrapings and smears are prescribed, and scales, crusts or plaque from the mucous membranes are also taken for examination;
hemotest to determine globulin levels. If their number exceeds the norm, then there is a high probability of infection;
general tests: feces, urine, blood. Necessary for suspected systemic candidiasis.

If the gastrointestinal tract is affected by fungal microorganisms, an endoscopic examination is performed. It is often prescribed to collect material for subsequent detailed laboratory study. Your doctor may also prescribe a colonoscopy, bronchoscopy, or x-ray.

How to cure candidiasis

A thorough preliminary study allows us to identify the type of fungus, as well as its sensitivity to certain bacterial preparations. If this is not done, the treatment will be ineffective and the disease will worsen. Under no circumstances should you self-medicate.

The doctor selects medications depending on what type of fungal infection has been identified. For elimination external manifestations Various antifungal ointments, gels, and creams are used. Concomitant diseases are treated, it is especially important to put the intestinal microflora in order.

At the same time, immunostimulating therapy is carried out. This includes taking vitamins, changing your lifestyle, and following the recommended diet. All flour products, sugar, alcohol and fatty foods are excluded. Drug therapy can be supplemented with folk remedies, but only after consultation with your doctor.

Any disease is easier to prevent than to treat. The presence of conditionally pathogenic microorganisms of the genus Candida does not in itself pose any harm to the body. People who do not have immunodeficiency, even with constant contact with the pathogen, do not get candidiasis, since the immune system copes well with the infection. Therefore, the main prevention is to maintain protective forces the body in a working active state. To do this you need to eat right, exercise physical exercise, do not run chronic diseases, undergo preventive examinations.

An important point is nutrition. Many foods provide a breeding ground for the active growth of yeast-like fungi. The most dangerous thing in this regard is sugar. Do not overindulge in sweets and baked goods.

Also exclude bad habits, try to avoid stress, and allow yourself to relax more in the fresh air. Take antibiotics only on the recommendation of a doctor and only together with probiotics.

Be sure to maintain personal hygiene. You should be especially careful in public places where it is humid and warm. This is a sauna, swimming pool, bathhouse.

Taking care of yourself is the basis of good health, and then no infections can cause harm and lead to illness. But if you suspect you have symptoms of a fungal infection, consult a doctor promptly, and then you can quickly cope with the disease.

Candida (Candida albicans). All representatives of this genus are classified as opportunistic.

Microorganisms of the genus Candida are part of the normal microflora of the mouth, vagina and colon of most healthy people. The disease is caused not simply by the presence of fungi of the genus Candida, but by their multiplication in large numbers, and/or the introduction of more pathogenic strains of the fungus. Most often, candidiasis occurs with a decrease in general and local immunity.

Etiology

Yeast-like fungi of the genus Candida belong to the imperfect fungi - deuteromycetes (anascospores). The most common species among patients are C. albicans and C. tropicalis.

Yeast-like fungi of the species C. albicans are unicellular microorganisms of oval or round shape. They form pseudomycelium (threads of elongated cells), blastospores (bud cells sitting on the constrictions of the pseudomycelium) and some chlamydospores - spores with a double shell. The main features that distinguish Candida fungi from true yeast are the following:

presence of pseudomycelium
absence of ascospores (spores in bags inside cells)
characteristic cultural features

Epidemiology

Most people encounter mushrooms Candida in the first year of life, and according to some data, in utero. The possibility of infection of the fetus is confirmed by the detection of fungi in the amniotic fluid, placenta, and umbilical cord membranes. In the future, contact of newborns with Candida fungi may occur during the period of birth canal, with the mucous membrane of the mouth, with the skin of the nipple when feeding, the skin of the hands when caring, as well as with food or household items. Significant contamination with these fungi was revealed raw meat, dairy products, as well as vegetables and fruits. The source, in addition to carriers, can be young domestic animals (calves, puppies, foals), as well as poultry.

Pathogenesis

Pathogenicity factors in fungi of the genus Candida include the secretion of proteolytic enzymes and hemolysins, dermatonecrotic activity and adhesiveness (the ability to attach to epithelial cells). All activation of virulence in opportunistic fungi of the genus Candida can be divided into three groups:

Exogenous factors facilitating the penetration of fungi into the body (temperature conditions, humidity, occupational hazards)
Endogenous factors causing a decrease in the resistance of the macroorganism (endocrine disorders, metabolic diseases, the use of hormonal contraceptives, courses of treatment with corticosteroid hormones, cytostatic drugs)
Virulent properties that ensure pathogenicity of the pathogen.

Clinical picture

Skin candidiasis

Nail candidiasis

Manifestations of candidiasis depend on the localization of the process.

There is a division into superficial and systemic (visceral) candidiasis.

Superficial candidiasis

Superficial candidiasis includes lesions of smooth skin, mucous membranes, candidal onychia and paronychia.

Yeast paronychia and onychia

Paronychia is characterized by edema, infiltration, hyperemia of the nail ridges, and absence of supracungual skin (eponychium). In this case, the periungual fold moves slightly onto the surface of the nail. Often paronychia and onychia exist simultaneously.

The fungus invades from the lateral areas and the periungual fold, so the free edge of the nail often remains unaffected.

Candidamicids

Candidamicides are secondary allergic rashes, indicating a significant degree of sensitization to the pathogen and its metabolic products. Polymorphic, usually in the form of erythematous-squamous edematous spots, but urticarial and bullous rashes are also possible. The appearance of candidamycids is accompanied by low-grade fever and an increase in the main inflammatory phenomena in the main foci.

Candidiasis of the oral mucosa (thrush)

Oral candidiasis.

This form is more common in newborns (but can occur at any age). The mucous membrane of the cheeks, as well as the tongue and pharynx, are covered with a whitish coating, reminiscent of snow flakes (they are also compared to cottage cheese, that is, the mucous membrane looks as if the child had just eaten cottage cheese or drank kefir). If the mother had similar manifestations in the vagina during or before pregnancy, or she experienced discomfort(itching) in the genital area (vaginal candidiasis), you can be sure that this is candidiasis. In most cases, oral candidiasis does not pose a danger if it is promptly and proper treatment. And only if the application local funds does not have an effect, it is necessary to seriously address the issue of the nature of this process.

Intestinal candidiasis

Intestinal candidiasis is one of the types of severe dysbiosis. In situations where conditions are created in the intestines that are unsuitable for the life of normal microbes, candida multiplies in it. This is manifested by diarrhea, excessive gas formation in the intestines, and there is an admixture of white flakes in the stool. For children early age This form of candidiasis is dangerous because they begin to lag behind in weight and height, and during diarrhea they lose vitamins and other beneficial substances necessary for normal growth and development.

Vulvovaginal candidiasis, balanitis and balanoposthitis

With candidiasis of the genital organs, abundant white, cheesy discharge is observed, and itching is characteristic. Vaginal candidiasis, as well as other forms, is characterized by an imbalance of normal microflora that lives on the mucous membrane. When treating vaginal candidiasis, it must be taken into account that, as a rule, the sexual partner must also be treated, since re-infection with the fungus is possible.

Symptoms of candidiasis in women

Burning and itching in the external genital area.
White, curd-like discharge from the vagina.
Pain during sexual intercourse.
Pain when urinating.

Symptoms of candidiasis in men

Burning and itching in the area of the glans penis and foreskin.
Redness of the glans penis and foreskin.
White plaque on the glans penis and foreskin.
Pain during sexual intercourse.
Pain when urinating.
White discharge when urinating, similar to semen

Chronic, generalized (granulomatous) candidiasis

Visceral candidiasis (systemic)

Cases of the spread of combined candidiasis with damage to internal organs and the development of candidal sepsis are registered in all countries.

Laboratory diagnosis of vaginal candidiasis

The cultural study should include not only the isolation and species identification of the causative agent of vaginal candidiasis, but also the determination of the sensitivity of the isolated strains to antifungal drugs. It is advisable to carry out sowing according to the following scheme: - using constantly the standard sowing technique, rotating the swab, inoculate the material on a plate with a chromogenic medium CANDICHROM II, when viewing the culture results, it is necessary to count the number of CFU of fungi various types (quantitative analysis). Use of chromogenic selective medium CANDICHROM II for primary culture allows direct identification of the main pathogen C. albicans and isolate other types of yeast (bacterial growth is inhibited by a mixture of antibiotics). Other types of mushrooms of the genus Candida, as well as pathogenic yeast fungi of other genera, can be reliably identified to species using a test system "Elichrom FUNGI". To determine sensitivity to common antifungal drugs (fluconazole, itraconazole, amphotericin B, voriconazole, flucytosine (5-fluorocytosine)) it is advisable to use a test system "FUNGIFAST AFG". Taking into account the likelihood of developing secondary resistance to azole drugs in fungi of the genus Candida, it is important to conduct susceptibility testing of isolated strains and before re-initiating treatment.

Treatment of candidiasis

There are many drugs to treat this disease. Some of them are used topically (cream, vaginal tablets or suppositories), others - orally (tablets or capsules for oral administration). Drugs for the treatment of candidiasis:

Among external treatments, a 5-10% solution of sodium tetraborate in glycerin topically is also effective. For damage to the mucous membranes of the mouth in adults, a 20% solution of sodium tetraborate in glycerin is applied topically.

In some cases, treatment is prescribed that complements antifungal drugs (immunotherapy, restorative drugs, physiotherapy, etc.), bacterial preparations of competing microorganisms (lactic acid bacteria, lactobacterin, colibacterin).

Therefore, to achieve complete cure and prevention reinfection It is necessary to take antifungal drugs not only locally, but also orally. Treatment of patients with chronic forms presents significant difficulties. Treatment failure may be due to insufficient dosage and duration, as well as individual insensitivity to one or another group of antifungal drugs. Therefore, it is necessary to conduct bacteriological studies (cultures) to determine sensitivity to antifungal drugs. It should be taken into account that fungi have the ability to quickly adapt and develop resistance to the drugs used.

For recurrent candidiasis (more than 4 exacerbations during the year), the following treatment options are possible:

Vaginal capsules with fenticonazole (Lomexin) 600 mg - on days 1 and 4 (two capsules).
Fluconazole (Diflucan, Mikosist, Flucostat) - 150 mg orally on days 1, 4, 7, then 1 capsule per week for 6 months.
Correction of conditions that provoke the development of candidiasis (diabetes mellitus, immunodeficiency, diseases requiring treatment with hormonal drugs)

Vaginal candidiasis is treated under medical supervision. If you are prone to relapse, especially in the presence of predisposing factors, it is necessary additional examination and observation by a doctor.

Prevention of candidiasis

A good way to prevent fungal growth is to eat yoghurts containing live lactic acid cultures, as well as natural products with good antifungal effect, such as garlic, propolis, hot red pepper, lingonberry berries and leaves, grapefruit juice and seeds, walnut leaves, tea tree oil.