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Candidiases — the diseases caused by drozhzhepodobny mushrooms.
Etiology. There is a large number of drozhzhepodobny mushrooms, but the main activator is Candida. Rod Candida includes 80 types. Most often Candida Albikans meets, formation of a pseudo-mycelium is characteristic of this sort. Being aerobes, Candida vaginas are saprophytes of mucous membranes of a mouth, guts; are capable to develop in various conditions of environment, well grow on many mediums (a beer must, Saburo's circle, a potato agar with bile, etc.).
Epidemiology. Drozhzhepodobny organisms are eurysynusic in the nature: outside covers and the digestive channel of the person and animals, fruits and berries, stalks and leaves of plants, some insects, water and the soil — here that incomplete list of objects which can serve as the reservoir of the specified mushrooms. Candidiases meet worldwide, is especially frequent in a belt of tropical and subtropical climate. Contageousness is small.
Pathogeny. Drozhzhepodobny mushrooms are normal saprophytes. Under certain conditions they can become the reason of heavy complications. With candidiases newborns often get sick. At children of advanced age and at adults, especially at persons of advanced and senile age, they develop more often when weakening an organism.
The significant role in developing of candidiases belongs antibiotiko-and hormonal therapy. Prolonged use of antibiotics leads to suppression of normal microflora of an organism. In conditions when the human body is weakened, broken synthesis of vitamins, there is an irritation or injury of mucous membranes (especially drugs of a broad spectrum of activity), low-pathogenic microorganisms become pathogenic for this patient and cause emergence of superinfection mushrooms, a stick of blue-green pus, staphylococcus, Proteus.
Clinic. Displays of candidiases are various. Drozhzhepodobny mushrooms possess ability to affect all mucous membranes, internals and systems in connection with a possibility of hematogenous distribution. Owing to clinical polymorphism candidiases are divided into 4 main groups: candidiases of mucous membranes, candidiases of skin and its appendages, visceral system candidiases and secondary allergic diseases.
Candidiasis of a mucous membrane of an oral cavity — the most frequent complication of therapy by antibiotics. In an initial stage the mucous membrane of an oral cavity accepts dark red coloring, becomes dry, smooth, then there are dot plaques, merging, they form whitish-grayish films. In the hard started cases plaques become dense and get grayish and dirty coloring, during removal them the erozirovanny bleeding mucous membrane is bared.
Candidiasis of a mucous membrane of almonds, pharynx and throat usually accompanies candidiasis of a mucous membrane of an oral cavity. On a surface of almonds, is more rare — handles whitish plaques appear. Pain when swallowing in most cases is absent, temperature does not increase, regional lymph nodes do not increase. At damage of a throat hoarseness of a voice, an aphonia, the complicated breath are noted. Visceral forms are shown in the form of pulmonary, intestinal forms and kandida-sepsis.
Candidiasis of lungs — one of the most often found antibioticotherapia complications, especially at elderly people and small children. Process can be primary, arise at inadequate therapy of sick ORZ, dysentery, during the postoperative period. Candidiasis of lungs happens secondary when the infection drozhzhepodobny mushrooms complicates the disease of lungs which developed at the patient before use of antibiotics. In lungs and sharply proceeding cases the disease reminds bronchitis and quickly passes after cancellation of antibiotics. In other cases candidiasis quite often accepts the menacing current, being followed by sepsis symptoms.
In an initial stage the disease is characterized by dry painful cough with a scanty phlegm. In lungs scattered dry and wet rattles. The general weakness, a fever, night sweat is noted. At further development of process the phlegm becomes mucopurulent, sometimes with blood streaks. Defeat has focal or drain character and has symptoms of pneumonia.
The course of candidosis pneumonia can be sluggish, long with periodic aggravations and recurrence. After improvement of a condition of the patient as a result of an antibioticotherapia gradual deterioration begins — against subfebrile temperature there is (or amplifies) dry and painful cough which is followed by allocation of a small amount of a viscous phlegm.
The X-ray pattern of kandida-pneumonia is various not only depending on a disease stage, but also from reactivity of an organism and is characterized by instability of manifestations. Radiological infiltrates are defined, is more often in the lower shares, inclined to merge. Disintegration of fabrics with formation of cavities is quite often observed. The pleura can be involved in process. Radical lymph nodes are increased and condensed. Diagnosis of candidiasis of lungs has to be based on comparison of a clinical picture, the course of a disease and results of laboratory researches in dynamics.
Candidiasis of digestive organs is quite frequent consequence of antibiotic treatment of dysentery and other intestinal infections. In mild cases of the phenomenon of intestinal candidiasis quickly stop after cancellation of antibiotics, the illness can sometimes gain long and persistent character.
In an initial stage appetite loss, nausea, vomiting, a liquid chair, sometimes with slime and blood, swelling and an abdominal pain, an itch in the field of an anus are observed. When progressing candidiasis there is organism dehydration, intoxication phenomena, an adynamia, false desires accrue.
Clinical recognition of a candidiasis of intestines is often complicated as the symptomatology generally differs from coloenterites and colitis of other etiology a little.
Diagnosis of this form is difficult available also when it is complication of dysentery and other intestinal infections. Sometimes the intestines candidiasis is mistakenly considered as chronic dysentery or its recurrence. As a result of the wrong diagnosis patients continue to receive antibacterial drugs that worsens their state, and sometimes and leads to development of generalized forms of a candidiasis and bacterial superinfections (staphylococcal, proteyny, etc.).
Candida sepsis on clinical manifestations a little in what differs from bacterial sepsis. It is necessary to emphasize that in all cases an indispensable symptom of kandida-sepsis is the milkwoman of an oral cavity. However at seriously ill patients the milkwoman of a mouth can arise also in the absence of visceral candidiasis, in a disease end-stage. Candida sepsis is usually characterized by a long heavy current, is followed by the progressing exhaustion and quite often comes to an end with death of the patient. For diagnosis of this form detection of the activator at blood crops is decisive. Drozhzhepodobny mushrooms of a sort Candida in blood of patients are found periodically therefore blood for bacteriological research should be taken during the first hours daily rise in temperature. Diagnostic value at clinical displays of sepsis can have also repeated detection of drozhzhepodobny mushrooms in urine.
The nature of candidiases comes to light on the basis of a complex of clinical, mycologic and immunological data. Underestimation conducts to diagnosis errors.
At all variety of clinical symptomatology and similarity to other diseases some signs allowing at attentive survey of the patient are inherent in candidiases if not to diagnose then to suspect a candidosis disease and to conduct laboratory researches for confirmation of the clinical diagnosis. The constant carriage of drozhzhepodobny mushrooms on mucous membranes, skin and detection them in various excretes (kcal, urine, a phlegm) obliges to belong carefully to finds of these mushrooms in the corresponding material. However at reception by the patient of antibiotics the similar microscopic picture is observed also without any changes of this or that body. These finds demonstrate that under the influence of an antibioticotherapia at the patient symptoms of dysbacteriosis developed that is a signal of possibility of candidiasis. Only repeated detection of a large number of elements of a mushroom, sometimes in the form of clusters, multiple budding, existence of a mycelium in combination with clinical changes give the grounds for the diagnosis of candidiasis. At 30 — 50% of healthy faces at crops of the corresponding material it is possible to allocate culture for mediums Candida. However receiving culture Candida from blood, cerebrospinal fluid, punctate of lymph nodes, the closed abscesses is the convincing proof that the patient has a candidiasis.
Directed by the diagnosis of visceral candidiasis serological tests of blood with kandida-antigens which are at such patients, as a rule, positive (RSK, agglutination tests and autoagglyutination in a caption 1 are of great importance: 160, 1: 320 and more).