Fungal diseases of various localizations occur in 20% of the world's population. Various pathogenic fungi become the culprit of their development. In total, about 500 species of such microorganisms can cause infectious diseases in humans. Fungi can attack different organs and systems. Sometimes their target is the digestive tract. As a result, a person develops a rather serious disorder, which brings significant physical discomfort and greatly harms health. Mycosis of the digestive tract in general and the stomach in particular cannot be ignored; this condition requires complex treatment under the supervision of a doctor.
What kind of disease is this?
Mycotic infection of the stomach occurs when this digestive organ is damaged by yeast-like, mold or dimorphic fungi. Most often, Candida albicans is the culprit. This fungus is considered opportunistic; it is found in moderate quantities in approximately 65% of people. Much less often, gastric mycosis occurs due to the proliferation of other types of candida. Non-candidal varieties of fungal infections of the gastrointestinal tract are extremely rare. Diseases provoked by pathogens of blastomycosis or histoplasmosis, etc., appear when fungi spread from lesions on the dermis, in the respiratory tract and other organs.
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Stomach fungus is rare and may be accompanied by some other somatic or bacterial pathology. Candida is often found on ulcer biopsies and is also associated with Helicobacter pylori.
Mycosis of the digestive tract can be localized not only in the stomach. Doctors also identify isolated lesions of the mouth and throat, esophagus, intestines, etc. Severe generalized infection is also possible.
Routes of transmission of the fungus and symptoms
Visceral mycosis in humans is caused by 3 types of fungi: candida, coccidoid and histoplasma, and, accordingly, diseases develop - candidiasis, coccidomycosis and histoplasmosis. They affect the respiratory, digestive and genitourinary systems, parasitizing the mucous membranes, in severe cases they enter the bloodstream, developing fungal sepsis and damage to all organs.
Transmission of the infection occurs through contact through damaged skin and mucous membranes, by airborne droplets and oral routes, through sexual contact, and possible activation of conditionally pathogenic fungi living in the body.
Symptoms of visceromycosis depend on which organ is affected, these may be:
- cough with phlegm;
- dyspnea;
- increased body temperature;
- frequent loose stools;
- painful urination;
- general weakness, lethargy, poor appetite;
- the appearance of a rash all over the body;
- areas of subcutaneous hemorrhage.
Important: at the first, even minor symptoms, especially in people of the listed risk groups, you should immediately consult a doctor.
Symptoms
This disease can be asymptomatic, manifesting only:
- belching;
- frequent nausea; periodic vomiting;
- discomfort in the epigastric area;
- decreased appetite;
- periodic stool disorders;
- heartburn, etc.
Stomach damage often develops against the background of peptic ulcer disease. Therefore, the patient is concerned about the symptoms of regular exacerbation of the ulcer. The disease cannot be treated in any way. This is what gives doctors reason to suspect the possible presence of a fungus. Most often, with mycosis in the stomach, the symptoms are completely implicit and mild in nature.
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Helicobacter bacterium: symptoms and causes
Abdominal pain, nausea, belching of air - all this may indicate that a dangerous, harmful Helicobacter bacterium has settled in the body, the treatment of which must be serious and thorough.
Helicobacter pylori is a very dangerous pathogenic microorganism that can lead to gastric and duodenal ulcers, gastritis and other diseases dangerous to the digestive system. Helicobacter was first discovered only 30 years ago. Medical research conducted since that time has proven that gastritis can have an infectious etiology. Also, according to studies of this bacterium, scientists have proven that, according to statistics, 75% of cases of stomach cancer in developed countries are caused by Helicobacter. In developing countries, this figure is even more frightening: 90% of patients with stomach cancer contracted the disease due to Helicobacter pylori.
Thus, it is worth pointing out the special role of early diagnosis of gastritis and gastric ulcers. It is a timely visit to a doctor that can save health and life.
Causes
Candida is present in non-pathogenic amounts on the skin and mucous membranes of absolutely healthy people. This fungus is successfully suppressed by microflora - beneficial bacteria. But candida can actively multiply and cause various health problems when the local protective reactions of the mucous membranes of the digestive tract are reduced. Mycosis of the gastrointestinal tract can develop against the background of:
- Physiological immune deficiency. A natural decrease in immunity is typical for pregnant women; the immune system does not work properly to avoid miscarriage. Also, the immune system does not function fully in newborns; the risk of fungal infection of the gastrointestinal tract in them increases with prematurity and genital candidiasis of the mother. In older people, the body's defenses gradually fade away.
- Pathological disorders of the immune system. HIV infection and its clinically expressed form, AIDS, can cause immune failure. But in fact, disruptions in the functioning of the immune system also occur for other reasons. These include cancer, thymic dysplasia, endocrine diseases, and starvation.
- Taking medications. The use of corticosteroids, immunosuppressants and other drugs can suppress the immune system and provoke the development of mycosis of the gastrointestinal tract. Mycosis of the gastrointestinal tract often develops in patients after chemotherapy and organ transplantation, as well as during the treatment of rheumatoid arthritis, systemic lupus erythematosus, etc. Inappropriate (irrational) antibiotic therapy can also cause fungus in the digestive tract.
- Violations of the integrity of the gastrointestinal mucosa. The risk of developing fungal infections of the gastrointestinal tract is higher in patients suffering from an atrophic form of gastritis, ulcerative lesions, gastroesophageal reflux disease, diverticulitis, Crohn's disease, etc. The likelihood of infection increases with burns, violation of the integrity of the epithelium by dentures, solid foods, and an intubation tube.
A fungus of the digestive tract can develop due to a combination of several provoking factors. The problem can be aggravated by a pronounced imbalance of nutrients in the daily menu, in particular, a lack of protein and vitamin compounds.
What does fungus in the body or mycosis mean?
Everyone knows about fungal diseases in humans, from newborn thrush to nail damage and hair loss. Less common are fungal infections of internal organs - the respiratory and digestive systems, when the fungus penetrates through the skin and mucous membranes deep into the body. As a result, mycosis develops, often in a severe and difficult to treat form.
About 500 species of fungi live in the human body, being conditionally pathogenic. This means that they may not cause disease if they are in bacteriological balance with other microflora and with a strong immune system. As soon as these parameters are violated, the fungi are activated, acquire pathogenic properties, and visceral mycosis develops.
Risk factors
The risk of gastric mycoses increases with:
- chronic form of alcoholism (especially when taking alcohol substitutes);
- hypoacid gastritis, which has been bothering the patient for more than 5 years;
- diabetes mellitus type 1 and 2;
- intestinal dysbiosis;
- autoimmune form of thyroiditis;
- Raynaud's disease.
As a rule, doctors can assume the presence of gastric candidiasis when they detect an ulcer or erosive gastritis in a patient that does not respond to standard treatment. There are several types of this disease.
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Varieties
There are 3 main types of fungal infections of the digestive tract:
| View | Description | Signs |
| Non-invasive | This is the most common type of disease. In such a situation, fungi do not penetrate the thickness of the intestinal walls, but multiply massively in the lumen of the organs. Their vital activity is accompanied by the release of a significant amount of toxic metabolites. Doctors suggest that the non-invasive form of candidiasis accounts for approximately a third of all episodes of intestinal dysbiosis. | The patient's condition remains satisfactory. Patients complain of moderate signs of intoxication, a feeling of discomfort, increased gas formation and insufficiently stable stools. Possible exacerbation of allergic diseases. |
| Invasive | Does not develop in patients with normally functioning immunity. It is characterized by the penetration of fungi into the thickness of the walls of the digestive tract. The disease can lead to damage to other organs (liver, pancreatic tissue, gall bladder, etc.). | Leads to a serious condition of the patient, increasing intoxication, and an increase in temperature. Patients complain of severe abdominal pain, diarrhea, and may have blood in their stool. |
| Invasive focal | This disease can complicate the course of ulcerative lesions of the gastrointestinal tract, nonspecific ulcerative colitis, etc. In this case, fungi begin to multiply very actively in places where epithelization of the mucous membranes is disrupted (for example, at the bottom of ulcers). | An invasive focal form of a fungal disease can be suspected by the persistent course of the background disease, which does not respond to standard treatment. |
Types by location
Fungal infection of the stomach is rarely isolated. Often this condition is complemented by other mycoses of the digestive tract:
| Form of the disease by location | Prevalence | Signs |
| Oropharyngeal | Very common. Often detected in newborns with an immature immune system. Can be found in patients with different types of immunodeficiency. Often provoked by microtraumas. | Pain while eating, discomfort, unpleasant taste in the mouth, whitish coating on the mucous membranes of the cheeks. As the disease progresses, the plaque becomes denser; if it is removed, a painful, ulcerated surface is revealed. |
| Esophageal | It can develop in patients with normal immunity, but more often it occurs when there is a malfunction of the body’s defenses. | Pain and discomfort when moving food (both solid and liquid), dysphagia, excessive salivation. |
| Intestinal | As a rule, it develops in the presence of defects in the intestinal walls or with gastric candidiasis, oropharyngeal lesions and esophageal infections. The risk of occurrence increases with improper antibiotic therapy. | Abdominal discomfort, disturbances in stool consistency and frequency, symptoms of moderate intoxication. The disease can cause exacerbation of allergic conditions. The patient may suffer from diarrhea, and mucus and blood may appear in the stool. There is often pain in the left side. Pathology leads to decreased performance and progressive weight loss. |
| Biliary | Happens quite often. It develops against the background of biliary dyskinesia, helminthic infestations, hypotension of the gallbladder, etc. The disease can be provoked by stones in the bile ducts. | It may manifest itself as discomfort, incomprehensible pain, disturbances in general condition (low-grade body temperature, weakness, impaired performance). |
Mycosis of the stomach can develop in the absence of proper treatment for the oropharyngeal form of the disease, after damage to the esophagus or intestines.
Candidiasis
Manifestations of candidiasis
Manifestations of candidiasis in women
Women experience the following symptoms of candidiasis (thrush):
- Swelling of the genital organs caused by inflammatory processes. Small vessels that are located on the mucous membrane gradually dilate, which is a reaction to the body's attempts to get rid of toxins secreted by fungi.
- Pain during intercourse. Often, fungi multiply on the vaginal mucosa, which leads to the destruction of the upper epithelial cells and damage to the deeper layers. This pathological process provokes the appearance of many small ulcers, which causes pain in the vaginal walls.
- White plaque. After infection of the body, the number of fungi rapidly increases, they form entire colonies on the genitals. As a result, inflammation occurs, which is accompanied by vaginal discharge that looks like curdled milk. Such secretions are damaged mucosal cells, leukocytes and fungal mycelium.
- Rash. In women, inflammation covers the labia minora and majora, and the vestibule of the vagina. As a result of damage to these organs by the fungus, the epidermis stratifies, which leads to the formation of vesicles - small pimples with liquid contents. Within a couple of days after their appearance, these pimples burst and small crusts appear in their place.
- Burning and itching. The main source of nutrition for fungi is glycogen stores in cells. As a result of the breakdown of glycogen, acids are released that cause a burning sensation. When washing and urinating, the discomfort only intensifies.
- Cystitis and urethritis. If fungi penetrate the urinary system, it leads to cystitis or urethritis. Symptoms of the transition of the inflammatory process to other organs are frequent urination, abdominal pain, and a sharp increase in temperature.
- Deterioration in health. Itching, burning, pain and discomfort provoke bad mood, sleep disturbances, and nervousness.
Manifestations of candidiasis in men
In men, the first clinical signs of candidiasis are diagnosed on the head of the penis. However, over time, the disease also affects the foreskin, groin area and scrotum. In men, candidiasis can take two forms: candidal balanitis - only the head of the penis is affected by the fungus, candidal urethritis - an inflammatory process appears in the urethra, as a result of which urination becomes painful.
As for the symptoms of pathology in men, these include primarily erosion, film, blisters and bright red spots on the head of the penis. All these pathological symptoms are usually accompanied by the appearance of a rash in the form of spots covered with scales. The rash appears as a reaction of the body to fungal infection. Men often complain of burning and itching in the genital area, which appears due to the fact that candida secretes enzymes that break down carbohydrates. As a result of this process, acids are released that actively affect the skin affected by candida.
Men with candidiasis experience symptoms such as redness and swelling due to the body's attempts to remove toxins by increasing circulation, a whitish coating consisting of immune cells, plasma proteins and skin cells. Often, a white coating occurs in the area of the coronary sulcus, between the foreskin and the glans. If the fungi have seriously damaged the skin, then after removing the white plaque, bright red spots appear in its place.
Another sign of candidiasis is inflammation of the foreskin. Due to a decrease in the protective functions of the skin, cracks may appear on the foreskin, in place of which scars then form. In the groin area, there is a significant increase and thickening of the lymph nodes, which becomes a reaction to cleanse the blood of toxins and microorganisms. A common symptom of candidiasis in men is pain during urination and sexual intercourse.
Generalized form of candidiasis
Generalized candidiasis is one of the most severe forms of chronic disease. The main causes of candidiasis include immunodeficiency with defects in the cellular and humoral immunity, hypofunction of the adrenal glands, diabetes mellitus, abnormal development of the thyroid gland, and deficiency of microelements such as zinc and iron.
The main features of the clinical course of this form of candidiasis include the following:
- The onset of pathology in the first months of a baby’s life.
- Multiple organ involvement. With this form of candidiasis, various organs are affected. Lumps, spots, and compactions appear on the skin. Nails thicken due to active keratinization of the nail bed. The surrounding tissues also become denser and redden. Plaque and erosion appear on the genitals. In addition, candidiasis can also affect internal organs - liver, intestines, kidneys, spleen, lungs, eyes.
- Tendency to relapse. In most cases, this type of candidiasis manifests itself for a long time exclusively as changes in the mucous membrane. In addition, in parallel with this lesion, infection of internal organs occurs. By the time the disease can be diagnosed, it turns out that the fungi have already infected the entire body.
- Ineffectiveness of antifungal therapy. Unfortunately, generalized candidiasis is currently an incurable disease, since it is impossible to cure yeast fungus with drug therapy. Therefore, treatment is usually aimed only at improving health, and not eliminating the disease.
Complications
Lack of adequate and timely treatment of mycoses of the digestive tract can lead to:
- penetration of fungi from the digestive tract to the tissues of the retroperitoneal tissue and the development of purulent-inflammatory processes (paraproctitis, paranephritis, interintestinal or subphrenic abscesses);
- generalization of fungal infection with the development of septicemia, in such a situation the fungus can spread to other organs;
- development of jaundice and liver failure (in case of damage to the hepatobiliary system);
- necrosis of the intestinal wall, including with perforation (rupture);
- profuse digestive bleeding;
- penetration (penetration) of ulcers into nearby organs.
If the fungus in the stomach is not treated, the symptoms of the disease will gradually increase. Timely diagnosis of digestive tract infection helps to avoid complications.
Diagnostics
Mycoses of the gastrointestinal tract are characterized by varied and rather nonspecific symptoms. Their course is similar to the manifestations of other pathologies of the digestive system. A doctor can make a correct diagnosis based on a number of informative research methods:
- Esophagogastroduodenoscopy. This is an endoscopic examination of the esophagus, stomach, and duodenum. With this intervention, the doctor places a gastroscope - a tube equipped with a camera - into the digestive tract. It helps to examine all parts of the gastrointestinal tract, see swelling, redness and a whitish coating. Doctors can also pay attention to the contact vulnerability of the mucous membranes and the presence of ulcerative defects. During an endoscopic examination, the doctor may collect material for examination (for histological analysis).
- Colonoscopy. This is another type of endoscopic examination that examines the large intestine. This procedure helps to assess the condition of the intestinal epithelium, identify erosions or ulcerative lesions of the mucous membranes (possible sources of bleeding), and perform a tissue biopsy at the affected sites. Colonoscopy is a good way to distinguish mycosis from other pathologies of the colon.
- Electrogastrography. This test is similar to electrocardiography of the heart. It involves recording the electrical signals that occur when the digestive muscles contract. With fungal infections, the motor-evacuation function of the stomach, as a rule, decreases. Against this background, pathogenic microorganisms begin to multiply more actively.
- Microbiological analysis of biopsy specimen. Tissues obtained from endoscopic examinations are sent to the laboratory. Laboratory technicians can identify fungi in the analysis, thereby confirming the diagnosis of mycosis. An acute process is indicated by active vegetation, complemented by the formation of mycelium.
- Serological reactions. This is a blood test that makes it possible to detect the presence of specific antifungal antibodies. It can be carried out at a certain interval - 10-14 days. If the antibody titer increases very actively, mycosis is more than likely.
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Additionally, patients with suspected gastrointestinal fungus may be prescribed a routine blood test. Mycosis leads to an increase in the level of ESR, an increase in the number of leukocytes, a decrease in the level of red blood cells and hemoglobin. To assess the structural features of all layers of the walls of the gastrointestinal tract, endoscopic ultrasonography is performed.
Treatment regimen
Therapy for mycosis of the stomach includes:
- following a diet selected by a doctor;
- correction of conditions that caused the activation of pathogenic fungal flora;
- destruction of pathogenic fungi using antimycotic drugs;
- the use of probiotics to restore the normal composition of intestinal microflora.
If necessary, doctors additionally use medications to stimulate natural immunity. It is possible to use herbal immunomodulators and various vitamin and mineral compositions.
Diet for mycosis
A proper diet is extremely important for fungal infections of the gastrointestinal tract. Good nutrition helps:
- quickly eliminate the fungus in the stomach;
- restore the normal state of mucous membranes;
- normalize the intestinal microbiota;
- prevent complications;
- adjust the chair, etc.
The nutritional pattern largely depends on the location and type of lesion. The superficial (non-invasive) process only requires limiting those foods that could become food for pathogenic fungi. And more serious processes are an indication for a strict and very gentle diet, selected by a doctor. Indeed, in this case, violations of the integral membranes occur in the digestive tract, so food should be comfortable for the mucous membranes.
Non-invasive mycosis requires exclusion from the daily diet:
- milk;
- sugar and sweeteners, any sweet drinks and confectionery, jams, dried fruits and jams;
- white rice, ordinary bread, pasta, and other flour products;
- all types of alcohol;
- sweet fruits (grapes, pears, figs, bananas);
- canned food, liver;
- nuts (mostly peanuts and cashews), sunflower seeds;
- fatty and fried foods, broths (meat, fish, mushroom);
Patients with fungal infections of the stomach will benefit from adding fermented milk products, garlic, onions, various herbs, freshly squeezed juices, berries (sea buckthorn, cranberries, currants, raspberries, bird cherry), cucumbers, beets, and sauerkraut to the menu.
It is worth noting that the listed healthy foods are strictly contraindicated for patients with ulcerative lesions, gastritis and acidity disorders. Indeed, in such conditions they can cause pain and other symptoms of exacerbation. The possibility of their consumption is determined by the doctor.
Diet for invasive mycosis
For patients with an invasive form of mycosis, nutrition must be selected especially carefully. Everyday food products should be gentle: not irritate or injure inflamed mucous membranes. Also, all products that can become food for the fungus are excluded from the menu. During the period of exacerbation of the disease, the diet should be especially strict:
- you need to eat 6-7 times a day in small portions;
- the diet may contain mucous soups made from oatmeal or pearl barley; you can add an egg-milk mixture or butter to them (with the approval of a doctor);
- Meat should be eaten lean, minced several times and cooked in the form of a soufflé;
- fish is also prepared as a steam soufflé;
- It is allowed to use pureed freshly prepared cottage cheese;
- liquid mucous porridges (buckwheat, oatmeal made from cereal flour) are allowed;
- you can eat up to 3 eggs a day;
- It is allowed to drink weak tea and rosehip decoction.
After the symptoms of exacerbation subside, the diet is gradually expanded in accordance with the doctor’s recommendations.
Treatment of fungus in the body
The problem of getting rid of fungus is very complex and requires complex and long-term treatment. Special antibiotics with targeted antifungal action are used: clotrimazole, nystatin, lamisil, nizoral, ketoconazole and other representatives of this group. Their selection is carried out individually for each patient after microbiological examination, isolation of the type of fungus and determination of its sensitivity to a particular drug. Fukortsin also deserves attention.
The treatment complex also includes immunostimulating agents, vitamins and detoxifying drugs. Diet plays a big role. You should exclude flour, butter and sweet foods and drinks, alcohol, as well as yeast bread. You need to introduce more seafood, fiber and vitamins in the form of cereals, vegetables and fruits into your diet.
Antifungal therapy
Drug treatment of mycosis in the stomach may include the use of different drugs:
| Group of drugs | What is he doing | Drug names |
| Antimycotics from the azole group | Destroy pathogenic fungi | Fluconazole, ketoconazole, itraconazole, voriconazole, posaconazole. |
| Antimycotics polyene | Causes the death of fungi | Nystatin, amphotericin, natamycin |
| Echinocandins | They interfere with the synthesis of the fungal wall, leading to the death of pathogens. | Caspofungin, anidulafungin, micafungin. |
| Pyrimidine | Destroys fungi or suppresses their growth and reproduction | Flucytosine |
Fluconazole
This is a powerful antifungal drug that can suppress the production of sterols in the cells of pathogenic fungi. Fluconazole destroys many types of Candida fungi in the stomach. When treating fungal infections of the gastrointestinal tract, it can be used both for oral administration (in tablet form) and for intravenous administration.
Fluconazole has few contraindications. It is not prescribed to patients:
- with an allergy to fluconazole, as well as to azole compounds that have a structure similar to the drug;
- taking terfenadine;
- taking medications that can prolong the QT interval (applies to cisapride, astemizole, as well as erythromycin, etc.).
For some patients, fluconazole is prescribed very carefully, with possible dosage adjustment. This applies to persons with:
- disorders of the liver;
- malfunction of the kidneys;
- skin rashes that occur while taking fluconazole;
- high risk of arrhythmia.
Fluconazole is also not prescribed to pregnant and breastfeeding women.
The dosage of the drug and duration of administration depend on the type of disease:
| Type of disease | Dosage on the first day | Further dosage | Duration of admission |
| Invasive mycosis | 400 mg | 200 mg | Depends on clinical effectiveness. |
| Non-invasive mycosis | 150 mg | 150 mg | From 14 to 30 days |
Fluconazole can cause a variety of side effects:
| Localization | Scroll |
| Gastrointestinal tract | Poor appetite, impaired taste perception, abdominal pain, vomiting, obsessive nausea, diarrhea, increased gas formation. There is a risk of liver dysfunction. |
| Nervous system | Excessive fatigue, headache, vertigo. There is a risk of seizures. |
| Hematopoietic | Decrease in the number of leukocytes, platelets, neutrophils. |
| Immune | Skin rashes and other allergy symptoms. There is a risk of anaphylaxis, toxic epidermal necrolysis, and erythema multiforme. |
| Cardiovascular | Heart rhythm disturbances, ventricular fibrillation. |
| Other | Malfunction of the kidneys, hair loss, increased cholesterol levels, as well as triglycerides. There is a risk of low potassium levels in the blood. |
Ketoconazole
This antifungal drug also helps destroy pathogenic fungi. It inhibits the production of ergosterol, triglycerides, and phospholipids, which are very important for the cell wall of pathogens. After ketoconazole enters the body, fungi can no longer form threads and colonies. The drug disrupts the permeability of cell membranes. Ketoconazole copes with yeast-like fungi of the genus Candida, mold fungal pathogens, and causative agents of systemic mycoses. It is used in tablet form for internal use.
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Contraindications to taking ketoconazole include:
- allergy to the components of the drug;
- acute liver diseases;
- period of bearing a child;
- breast-feeding.
The drug also has a number of restrictions on its use. Dose adjustment and especially careful use are required in patients with:
- decreased function of the adrenal cortex and/or pituitary gland;
- severe renal and liver failure;
- concurrent treatment with hepatotoxic agents.
The dosage of the drug depends on the severity of the disease:
| Type of disease | Initial dosage | Further dosage |
| Non-invasive lesion | 1-2 tablets (0.2 g) per day for 2 weeks | 1 tablet per day for 4-6 weeks |
| Invasive lesion | 2 tablets per day for 2 weeks | 1 tablet per day for several months |
The drug is usually well tolerated by patients. However, ketoconazole may cause some unwanted reactions:
| Localization | Description |
| Nervous system, sensory organs | Increased drowsiness, paresthesia, headache, vertigo. |
| Gastrointestinal organs | Decreased appetite, obsessive nausea, vomiting, possible diarrhea and pain in the abdominal area. There is a risk of liver dysfunction. |
| Genitourinary system | Decreased libido, gynecomastia (enlarged mammary glands in men), potency and menstrual cycle disorders. |
| The immune system | Skin rashes, hives, itching and other allergy symptoms. |
| Other | Photophobia, hair loss, joint pain, fever, decreased platelet levels. |
Itraconazole
This is a strong antimycotic that can suppress the production of an important component of the cell membrane of fungi. Itraconazole is able to destroy many fungal pathogens, including those that cause fungus in the stomach (yeasts and molds). This medicine quickly penetrates the blood and spreads throughout all tissues and biological fluids of the body.
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Itraconazole has few contraindications. It is not prescribed for allergies to its components, pregnancy, or breastfeeding. They also try not to prescribe the drug to people with cirrhosis of the liver, heart and kidney failure. For such categories of patients, the drug is prescribed if the expected benefit from its use is higher than the potential risk.
The dosage regimen depends on the severity of the disease:
| Severity of the disease | Dosage per day | Duration of treatment |
| Limited stomach fungus | 100 mg | 15 days |
| Systemic mycosis of the gastrointestinal tract, non-invasive | 100-200 mg | 3 weeks - 7 months |
| Systemic mycosis of the gastrointestinal tract, invasive | 200 mg | Up to 7 months |
Itraconazole can cause various side effects.
| Localization | Description |
| Gastrointestinal organs | Dyspeptic symptoms, abdominal pain, nausea, loss of appetite, anorexia, vomiting, stool disorders. Possible disturbances in the activity of the liver (even toxic damage to this organ). |
| Nervous system, sensory organs | Vertigo, headache, peripheral neuropathy, excessive fatigue, severe drowsiness. |
| Heart, blood vessels, hematopoietic system | Increase in blood pressure. There is a risk of developing chronic heart failure. |
| Genitourinary system | Severe pain during menstruation (dysmenorrhea), edema syndrome, protein in the urine, darkening of the urine. |
| The immune system | Different types of allergic reactions: itching, rashes, urticaria. Angioedema and Stevens-Johnson syndrome may occur. |
| Other | Hair loss, decreased potassium levels, pulmonary edema, loss of libido, potency disorders. |
Nystatin
This antifungal drug is effectively integrated into the cell membrane of pathogenic fungi. After this, the drug components form many channels that promote the uncontrolled passage of water, electrolyte and non-electrolyte elements. As a result of such changes, the fungal cell becomes completely unstable to external influences and is destroyed.
Nystatin copes with yeast and yeast-like fungi, and is active against aspergillus. It is poorly absorbed by the walls of the digestive tract and is excreted mainly unchanged in the feces. As a rule, this drug is prescribed to patients with non-invasive fungal infections of the gastrointestinal tract.
Nystatin has several contraindications; the drug is not prescribed for:
- allergies to components;
- disruptions in liver activity;
- inflammation of the pancreas;
- ulcerative lesions of the gastrointestinal tract.
Nystatin tablets are intended for internal use. They should be swallowed whole without chewing. The dose should be taken 40-60 minutes before meals. The medicine should be taken with water (about half a glass). Standard dosage of the drug for adults: 1 tablet 3-4 times every 24 hours. In severe cases of the disease, the doctor may prescribe up to 12 tablets per day.
Nystatin can cause a variety of negative reactions:
| Localization | Scroll |
| Gastrointestinal tract | A feeling of bitterness in the mouth, dyspeptic symptoms, nausea, vomiting, diarrhea, soreness, loss of appetite. |
| The immune system | Hyperthermia, chills, various allergic symptoms (itching, skin rashes, urticaria, anaphylaxis, etc.). |
| Others | Increased sensitivity to ultraviolet radiation, heart rhythm disturbances, muscle pain. |
Amphotericin
This polyene antibiotic has antifungal and fungicidal properties. It is able to bind to the sterol component of the fungal cell membrane, disrupting its barrier abilities. As a result, fungi sensitive to the drug undergo lysis. Amphotericin B is capable of destroying many types of Candida; it copes with the provocateurs of deep and systemic mycoses. Intended for intravenous administration.
Amphotericin B has few contraindications and is not prescribed to patients with:
- allergy to the components of the drug;
- severe disruptions in the functioning of the liver or kidneys;
- diseases of the hematopoietic system;
- diabetes mellitus
They try not to prescribe the medicine to pregnant and lactating women, since it is unknown how safe its use is in such categories of the population.
The dosage of amphotericin B is selected depending on the patient's weight. Doctors usually prescribe 250 units/kg. Initially, a smaller dosage is used to determine individual tolerance. If necessary, the dose can be increased to 1000 units/kg.
Amphotericin B is used for intravenous drip administration. The drug is diluted with water for injection in accordance with the instructions, shaken so that the powder is completely dissolved. The administration is carried out over 3-6 hours - 20-30 drops per minute.
Amphotericin B can cause various side effects:
| Localization | Description |
| Nervous system, sensory organs | Visual impairment, double vision, polyneuropathy, headache. |
| Cardiovascular and hematopoietic system | Fluctuations in blood pressure, heartbeat disturbances, ECG changes, decreased levels of white blood cells and platelets, anemia. |
| Gastrointestinal organs | Nausea, vomiting, loose stools, abdominal pain, loss of appetite, changes in the activity of liver enzymes. |
| Genitourinary system | Malfunction of the kidneys, an increase in the level of creatinine in the blood, protein in the urine, etc. |
| The immune system | Skin rashes, itching and burning, Quincke's edema. |
| Other | Increased temperature, chills, changes in the electrolyte composition of the blood (decreased potassium and magnesium levels), thrombophlebitis in the injection area. |
Caspofungin
This drug is used to treat invasive candidiasis and is also prescribed to patients with invasive aspergillosis. Caspofungin is able to suppress the production of an essential component of the cell walls of pathogenic fungi, which leads to the death of organisms. The drug is intended for intravenous administration.
Contraindications to the use of caspofungin include:
- allergy to the components of the drug;
- concurrent use of cyclosporine;
- liver failure in severe and moderate form;
- childhood;
- pregnancy and breastfeeding.
Fungus in the stomach requires slow intravenous administration of caspofungin. For adult patients, a single dose of 70 mg of the active substance is recommended on the first day. Further therapy requires the administration of 50 mg of the drug per day. If the patient weighs more than 80 kg, the initial dosage remains the same, and the further dosage is 70 mg per day.
Caspofungin can cause a variety of side effects:
| Localization | Description |
| Gastrointestinal organs | Nausea, vomiting, loose stools, increased levels of liver enzymes, changes in the amount of direct and total bilirubin, pain in the abdominal area. |
| Genitourinary system | Increase in creatinine level. |
| Cardiovascular and hematopoietic system | Redness of the facial skin, heart rhythm disturbances, increased blood pressure. |
| The immune system | Skin rashes, swelling, itching, feeling of heat, bronchospasm, anaphylactic symptoms. |
| Other | Chills, increased body temperature, headaches, shortness of breath, decreased levels of potassium and magnesium in the blood. |
Flucytosine
After penetration into the fungal cell, it is transformed and integrated into the RNA of the pathogen. This leads to disruption of protein synthesis and destruction of pathogenic pathogens. Flucytosine can be used in the treatment of fungal diseases of the stomach; it effectively destroys the fungus Candida, Aspergillus, etc. It is considered to have low toxicity for humans.
Flucytosine has a number of contraindications. It is not prescribed to patients with:
- allergy to the components of the drug;
- chronic renal failure;
- depressed bone marrow function;
- blood diseases.
Flucytosine is also not indicated for pregnant and breastfeeding women.
The drug is used for intravenous administration. However, it is often combined with amphotericin B. However, flucytosine cannot be used as a monotherapy. In this case, fungi can easily develop resistance to it. Also, monotherapy with flucytosine is not as effective.
The drug can cause various side effects:
| Localization | Description |
| Cardiovascular system, hematopoiesis | Cardiac arrest, heart rhythm disturbances, anemia, drop in the level of leukocytes, platelets, anemia (aplastic, hemolytic), increase in the level of eosinophils. There is a risk of inhibition of hematopoietic processes. |
| Respiratory system | Respiratory arrest, chest pain, shortness of breath. |
| Skin | Rash, itching, urticaria, increased sensitivity to light, toxic epidermal necrolysis. |
| Digestive tract | Nausea, abdominal pain, vomiting, diarrhea, exhaustion, dry mouth, gastrointestinal ulcers, bleeding in the intestines and stomach, ulcerative colitis. There is a risk of disturbances in liver activity, including the occurrence of acute liver failure. |
| Genitourinary system | Azotemia, an increase in the level of creatinine, urea, and nitrogen. Crystalluria and acute renal failure may develop. |
| Nervous system and sensory organs | Impaired coordination of movements, abnormal fatigue, weakness, headache. There is a risk of paresthesia, peripheral neuropathy, vertigo, parkinsonism. The development of convulsions, sedation, loss of consciousness, hallucinations, psychosis, and hearing impairment may occur. |
| Other | Various allergic reactions, an increase in temperature, a decrease in blood sugar and potassium levels. |
Micafungin
This antifungal substance powerfully inhibits the production of an important component of the fungal cell wall, thereby killing pathogens. At the same time, the drug does not affect healthy cells of the body in any way, since its target is absent in mammalian cells. Micafungin is active against various species of Candida, Aspergillus and dimorphic fungi. The drug is intended for intravenous administration. Among the contraindications to its use:
- allergy to micafungin and other echinocandins;
- pregnancy;
- breast-feeding.
Micafungin can cause serious disturbances in liver activity, which should be taken into account when prescribing it. Patients with diseases of this organ are treated after assessing the risk-benefit ratio.
The dosage of micafungin depends on the type of mycosis and the patient’s weight:
| Purpose of the drug | Weight more than 40 kg | Weight less than 40 kg | Duration of therapy |
| Prevention of relapse | 50 mg/day | 1 mg/kg/day | 1 week after neutrophil levels stabilize |
| Non-invasive fungus | 150 mg/day | 3 mg/kg/day | 1 week after symptoms disappear |
| Invasive mycosis | 100 mg/day | 2 mg/kg/day | Minimum 14 days and 1 week after 2 consecutive negative blood test results. |
If necessary, the dosage can be increased to 200 mg/day or 4 mg/kg/day.
Micafungin is a fairly strong drug that can cause various side effects:
| Localization | Description |
| Blood, lymphatic system | Decrease in the level of leukocytes, neutrophils, platelets, increase in eosinophils. Anemia, pancytopenia, and hypoalbuminemia may occur. |
| The immune system | There is a risk of anaphylactic and anaphylactoid reactions, hypersensitivity reactions. |
| Metabolism, nutrition | Decreased levels of potassium, magnesium and calcium in the blood. There may be a decrease in sodium, potassium, and phosphate levels. There is also a risk of complete loss of appetite, up to anorexia. |
| Psyche | Sleep disturbances, anxiety, symptoms of altered consciousness |
| Nervous system | Headache. There is a risk of vertigo, drowsiness, tremors, and taste disturbances. |
| Heart | Heart rhythm disturbances: tachycardia, bradycardia, rapid heartbeat. |
| Vessels | Phlebitis, decreased or increased blood pressure, hyperemia. There is a risk of shock. |
| Respiratory system | Dyspnea |
| Digestive tract | Nausea, vomiting, stool disorders, dyspepsia, abdominal pain. |
| Liver, biliary system | Increased liver enzymes, cholestasis, jaundice, liver failure, etc. |
| Skin and subcutaneous tissue | Skin rashes, hives, itching and burning. There is a risk of hyperhidrosis, erythema multiforme, Stevens-Johnson syndrome, etc. |
| Kidneys, urinary tract | An increase in the level of creatinine, urea in the blood, an increase in renal failure, malfunction of the kidneys, an acute form of renal failure. |
| General and injection site reactions | Fever, chills. There is a risk of blood clot formation, pain and inflammation at the infusion site, and peripheral edema. |
Additional medications
Treatment of gastric mycosis, which has developed against the background of other health problems, requires the use of various systemic drugs:
- the patient’s presence of chronic inflammatory processes in the stomach may require taking glucocorticoids with minimal systemic side effects;
- impaired immune resistance - an indication for the use of mild immunomodulators;
- treatment of ulcerative lesions of the gastrointestinal tract requires the use of antisecretory drugs, preference is given to proton pump inhibitors (Nexium, Pariet, Lanzap);
- if necessary, patients with ulcers are additionally prescribed blockers of histamine H2 receptors (for example, quamatel, ulferan, etc.);
- when Helicobacter pylori is detected, antibacterial drugs are used extremely carefully, since antibiotics lead to the activation of fungi;
- Patients with AIDS need to take prescribed antiretroviral therapy medications, otherwise the fungus will constantly recur.
The doctor selects the treatment regimen. The patient needs to scrupulously adhere to medical recommendations; only in this case can recovery be achieved.
Reasons leading to the development of mycosis of internal organs
The following factors can lead to activation and increased reproduction of fungi that previously peacefully coexisted in the body:
- Long-term use of antibiotics, especially modern, broad-spectrum ones. They kill not only pathogenic, but also beneficial microbes that inhibit the development of fungi. And the fungi themselves are very resistant to antibiotic therapy.
- Taking chemotherapy drugs in cancer patients, which suppress both the immune system and the protective microflora in the body.
- Long-term use of hormonal drugs - corticosteroids, which reduce immunity.
- Immunosuppressive drugs used in people with organ transplants to suppress the immune system and prevent rejection.
- Ionizing radiation is radiation treatment or increased background radiation that sharply suppresses the immune system.
- Blood diseases - anemia, leukemia.
- Immunodeficiency - after serious illnesses, with HIV infection, chronic intoxication in those who abuse alcohol, drugs, and smoking.
- Chronic diseases with circulatory and metabolic disorders: diabetes mellitus, hypofunction of the thyroid gland, liver and kidney failure, dysbacteriosis, systemic diseases, severe forms of allergies.
- Age-related immunity deficiency - in infants and the elderly.
- Sedentary lifestyle, overweight.
- Stressful situations that reduce the body's protective properties.
- Failure to comply with sanitary and hygienic rules.
- Surgical operations, the presence of wounds, abrasions, abrasions, ulcers, rashes on the skin and mucous membranes.
- Unfavorable environmental conditions.
Often these provoking factors are combined. For example, unprofessional antibiotic treatment of pneumonia in infants without the use of antifungal agents.
