Candidiasis: what is it?

CANDIDIASIS

(
candidosis
; synonym:
candidiasis, superficial blastomycosis, soormycosis, candidiasis, moniliasis, oidiomycosis
) is an infectious disease of the skin, mucous membranes and internal organs caused by yeast-like fungi (fungi of the genus Candida).

The disease was first described by B. Langenbeck in 1839, although it has been known since the time of Hippocrates under the names stomata aphtoides and aphta infantis (K. Galek). In 1848, F. Th. Berg first established the presence of yeast-like fungi in the tissues of a sick person. Berkhaut (M. Berkhaut) in 1923 identified the genus Candida among yeast-like fungi. The term Candida was adopted in 1939 by the III International Congress of Microbiologists.

Candidiasis occurs in all countries of the world, especially often in tropical and subtropical climates. The number of patients with various clinical forms of Candidiasis, especially visceral ones, has a slight upward trend.

What pathogens provoke thrush?

Thrush occurs due to pathological changes in the vaginal microcenosis caused by the activation of yeast-like diploid fungi of the genus Candida. In 80% of cases, Candida albicans is detected. Candida is a conditionally pathogenic unicellular organism, a tiny part of which is part of the human microbiological flora.

95% of the microcenosis of the female vagina is made up of beneficial resident bifidobacteria and lactobacilli, which synthesize lactic acid. Potential causative agents of urogenital diseases are conditional pathogens. They make up the remaining 5%. The microbial ratio of 95:5 ensures a constant pH (acidity) level that protects the female reproductive system. Fungal infection occurs when the reference amount of candida albicans increases.

During the period of activity, vaginal fungi exhibit high virulence (the ability to infect a woman’s body) and contagiousness (transmission to a partner). Candidiasis is not usually classified as a sexually transmitted infection, but with unprotected intimacy and oral-genital contact, active fungi spread to the male mucous membranes (genitals, oral cavity). Men are classified as candida carriers. Severe symptoms of thrush in men with the subsequent development of candidal urethritis and candidal balanoposthitis are diagnosed with a low level of immunity.

At Polyclinic +1, thrush and its complications in men are treated by experienced venereologists with 20 years of experience. To avoid relapse in women and infectious risks in men, our clinic provides synchronous treatment for both partners. Therapy is carried out anonymously, according to a personal scheme.

Untreated vulvovaginal candidiasis in pregnant women is transmitted to the newborn during delivery (when the baby passes through the birth canal).

What causes a violation of vaginal microcenosis

The key trigger for imbalance of the vaginal microenvironment is suppression of the functions of the immune system. The reasons for decreased immunity and activation of candida are endogenous or exogenous. The endogenous source is internal disturbances in the functioning of organs and systems; the exogenous factor is associated with habits and lifestyle.

Endogenous causes of microcenosis imbalance:

• local (vaginal) immunodeficiency;
• changes in hormonal status (perinatal and menopausal periods);
• hormonal imbalance caused by endocrine diseases (hyper- and hypothyroidism, diabetes mellitus, etc.);
• human immunodeficiency virus (HIV);
• anorexia, cachexia (extreme exhaustion of the body);
• recurrent chronic pathologies of the genitourinary system (glomerulonephritis, pyelonephritis, endometritis, salpingoophoritis);
• prolonged psycho-emotional overload (distress);
• severe alcohol, drug, industrial intoxication.

Vaginal candidiasis develops against the background of intestinal dysbiosis, acute and chronic STIs (sexually transmitted infections).

Exogenous causes include:

• self-medication with drugs from the pharmacological group of antibiotics;
• long-term therapy with hormone-containing medications, cytostatics (antitumor drugs);
• abuse of intravaginal suppositories with a pronounced spermicidal effect;
• uncontrolled use of antiseptics when douching;
• frequent use of antibacterial soap for genital hygiene;
• incorrect means of contraception;
• gastronomic cravings for sweets;
• passion for diets that limit the consumption of fermented milk products;
• constant contact of the external genitalia with synthetic underwear;
• neglect of intimate hygiene.

Violation of the microbiological flora of the vagina causes individual hypersensitivity to certain types of sanitary pads, tampons, and intimate perfumes.

Main causes of candidiasis

1. Infection with fungi through sexual contact. — Candida can get on the genitals, rectum, oropharynx, lips of a healthy sexual partner when his mucous membranes come into contact with the secretions of an infected person. This happens during classic vaginal contact, oral and anal sex.
2. Long-term antibiotic therapy. — In this case, the balance between bacteria and fungi Candida albicans is disrupted, which results in active proliferation of fungi against the background of a decrease in the number of normal bacteria. It occurs most noticeably in the intestines and vagina of women.
3. Treatment with immunosuppressants and cytostatics. — The immune system is suppressed, which ceases to control the proliferation of fungi.
4. Diabetes mellitus - an increase in blood glucose levels leads to high levels of glucose in the urine and mucous membranes, which is a favorable environment for the spread of candida.
5. Intestinal dysbiosis associated with a decrease in the number of bifidobacteria and lactobacilli, which normally inhibit the activity of fungi.
6. Frequent vaginal douching, especially with the use of antiseptics, also destroys normal microflora and creates a favorable situation for the growth of fungal flora.
7. Increased sweating in the area of ​​the folds of the skin of the groin, perianal, axillary, under the mammary glands.
8. Some types of candida are capable of multiplying on the surface of vegetables and fruits and infecting the skin and nails of people working with them.

The question arises - what is candidiasis? A sexually transmitted infection, or some kind of disorder within the body?

Candidiasis symptoms and treatment are so diverse and depend not only on the clinical manifestations, but also on the reasons that caused this process.

That is why self-medication of candidiasis without the supervision of a specialist in almost 100% of cases ends in temporary imaginary relief and the development of a chronic disease with periodic relapses.

Only a doctor who has extensive experience and has been dealing with this pathology for many years can carry out a correct diagnosis and select treatment for candidiasis, including therapy with antifungal drugs and local procedures. Simply taking fluconazole capsule or other tablets, as is widely used by everyone, leads to the effects described above.

What are the symptoms of thrush in women?

Candidiasis occurs in asymptomatic, acute or chronic form. The intensity of thrush symptoms is influenced by the initial state of the genital mucosa, the level of the pain threshold, the performance of the immune system, endocrine pathologies, and STIs.

Primary manifestations

In the initial phase of candidiasis, a woman is bothered by discomfort in the vaginal area. Genital discomfort increases during the premenstrual period. As Candida albicans becomes more active, nonspecific vaginal discharge appears—leukorrhea. Fungal mycelium changes the amount and consistency of leucorrhoea. They become abundant and thick. They have a characteristic off-white color. During their life, fungi release organic compounds with a sour-milk odor, which is why leucorrhoea smells unpleasant. Vaginal secretions that have dried on a pad or underwear cause irritation of the labia minora mucosa. There is hyperemia (redness) of the external genitalia. A woman experiences discomfort during sexual intercourse.

Acute symptoms

Acute vulvovaginal candidiasis is characterized by an increase in primary manifestations. With the large-scale spread of fungi, symptoms of urogenital infectious and inflammatory diseases arise.

Vaginal discharge

The vaginal secretion acquires a pasty, curd-like density and a grayish-yellow hue. Foci of cheesy plaque appear on the mucous membrane (in the folds of the labia, under the skin fold of the clitoris, on the vulva). The plaque adheres tightly to the genitals and is difficult to clean mechanically. After its removal, weeping erosions and macerations (corroded tissue) remain on the surface of the mucosa. The volume of discharge increases to 15 ml (1 tbsp).

Appearance

Due to inflammation, the external genitalia are hyperemic, swollen, and covered with a thick whitish coating. Permanent irritation provokes a violation of the integrity of the mucous membrane and the appearance of bleeding microcracks.

Itching and burning

Constant irritation of the vulva and vaginal mucosa by fungal mycelium causes itching of the genitals and perineum. Due to the peculiarities of the anatomical structure of the female genital organs (wide and short urethra), Candida microorganisms quickly penetrate the urethra. Pollakiuria (frequent urination) develops, accompanied by burning and stinging. Itchy sensations intensify after hygiene procedures, intense physical activity, and during menstrual flow.

Painful sensations

With the further development of thrush, dyspareunia occurs - pain in the genital area during and after intimacy. Soreness is caused by microcracks and maceration on the mucous membrane. When inflammation spreads to the internal genital organs, aching pain appears in the lower abdomen, radiating to the lumbar region.

Smell

The progression of thrush is accompanied by an increase in unpleasant odor. Fungal mycelium mixes with secretions of the sebaceous glands, cervical canal and urine. The lack of local immunity and a shift in vaginal pH provoke the activity of opportunistic bacteria inhabiting the microflora. The appearance of the smell of rotten fish indicates the addition of bacterial vaginosis.

Other symptoms

As a result of permanent itching, irritability, sensitivity, nervousness appear, and sleep is disturbed. Psycho-emotional instability provokes cephalgia (headaches) and absent-mindedness. A weakened body loses its ability to bear the usual loads.

Clinical symptoms

Candidiasis of the mucous membranes

Yeast stomatitis

(see), or so-called. thrush occurs mainly in weakened infants and small children or in elderly people against the background of chronic diseases. Initially, on the unchanged mucous membrane of the cheeks, hard and soft palate, tongue and gums, pinpoint white deposits form, which, merging, form white films reminiscent of curdled milk. If you remove the films, you will find a bleeding mucous membrane underneath them. When a child has thrush, nipple pain may occur in a nursing woman: the skin turns red, bubbles and cracks appear on the nipple, and severe pain during feeding.

Yeast glossitis

(see) - in addition to thrush, atrophy of filiform papillae can be observed in some areas of the back of the tongue; in some patients, deep grooves of the tongue are significantly pronounced (tsvetn. Fig. 1), in which whitish deposits are visible; the entire tongue is slightly enlarged due to swelling. K. of the mucous membranes is not a serious disease, but it is a symptom indicating a general weakening of the body; Yeast glossitis is often observed in older people who wear dentures.

Candidal tonsillitis

(see) usually occurs chronically with normal body temperature and absence of pain when swallowing. Whitish plugs form on the tonsils, but there may also be plaque in the form of white films. Regional lymph nodes are not involved in the process.

Vulvovaginal candidiasis

(see) is detected by the appearance of whitish discharge, crumbly in nature. On the mucous membrane of the vagina, the edges are usually hyperemic, whitish or gray plaques and superficial erosions are found. Patients note itching and burning in the external genital area. K. is often combined with Trichomonas colpitis.

Candidiasis balanitis and balanoposthitis

(see Balanitis, balanoposthitis) - white plaques form on the head of the penis, on the inner layer of the foreskin and less often on the outer layer, under which surface erosions are found; rashes are accompanied by burning and pain.

Skin candidiasis

Candida infection

may occur as an independent disease or be a manifestation, for example, of thrush.
Yeast infection is characterized by a predominance of maceration and detachment of the upper sections of the stratum corneum in the form of a border around cracks in the corners of the mouth and significant infiltration at their base (see Zaeda). Rice.
1. Candidal cheilitis (grayish scales on the swollen red border of the lips) and glossitis (whitish coating, deep furrows on the tongue). Candidal cheilitis

(see) is characterized by redness of the red border of the lips, dryness, a feeling of tightness and burning.
The grayish scales seem to be glued to the red border of the lips, and their free edge is slightly raised (color fig. 1); To diagnose candidal cheilitis, repeated detection of fungal elements is necessary. Rice.
2. Candidiasis of large skin folds - damage to the folds of the anus and intergluteal fold with a characteristic border of macerated epidermis. Intertriginous K.

(large folds) occurs quite often. The axillary fossae, folds of skin under the mammary glands, especially in obese women, intergluteal and inguinal-femoral folds may be affected (color. Fig. 2). With this localization, large lesions with clear boundaries are formed, often with erosion and weeping. The periphery of the lesions is surrounded by a border of whitish macerated epidermis. Around the main focus, especially under the mammary glands, small lesions of the same nature (so-called daughter elements) are often found.

Interdigital candidiasis erosion

brushes occurs very often, sometimes as a manifestation of an occupational disease (occupational K.). Usually the process develops in the third interdigital fold, less often in others. The stratum corneum in the fold is swollen, macerated, and has a pearlescent tint. In the center of the lesion, an eroded red surface is found, moist and shiny due to moderate weeping. The process does not extend beyond the lateral surfaces of the main phalanges. Erosion occurs quite persistently and, without eliminating pathogenetic factors, is prone to relapse. Patients note itching and burning.

Candidiasis of small skin folds

(behind the ears, in the navel area, interdigital folds of the feet) is common. The process is characterized by the same wedge signs as when localized in large folds, and can be either the primary manifestation of K. or develop along with signs of another disease.

Other manifestations of smooth skin candidiasis can be found in the form of erythematosquamous, vesiculobullous, scarlet-like and psoriasiform rashes. Candida erythroderma is also rarely observed.

Candidiasis of the nail folds and nails

(onychia and paronychia) is usually observed only on the hands, as an occupational disease among workers at fruit processing enterprises.
Rice.
3. Candidal onychia (thickening and clouding of the nail plates) and paronychia (inflamed nail folds, no eponychium). The process often begins with the nail fold, which becomes hyperemic, “cushion-shaped”, the cuticle disappears, and when pressed, a small drop of pus is released; The acute stage gradually turns into subacute and chronic. Later, the nail plate is involved in the process, the edges gradually become bumpy with transverse stripes and depressions or become thinner, sometimes easily peeling off. The color of the affected nail plates is brownish, less often with a greenish tint. Yeast paronychia and onychia (tsvetn. Fig. 3) can be the only manifestation of K. or combined with other forms of superficial or even visceral K.

Visceral Candidiasis

Rice.
4. Chronic generalized (granulomatous) Candidiasis - on the scalp and body of the child there are flaky infiltrated spots and tubercles with horny deposits. Chronic generalized (granulomatous) Candidiasis

- an independent wedge, variety K. As a rule, the disease begins in early childhood with thrush of the oral mucosa. Then, the process gradually involves the nail folds and nail plates of the hands and feet, the scalp, the skin of the face, torso and limbs. Frequently observed yeast cheilitis, especially damage to the lower lip, leads to the development of macrocheilia. Characteristic is the subsequent appearance on the skin of the scalp, face, torso and extremities of hyperemic and flaky spots with infiltration at the base, papules, tubercles and horny deposits (color. Fig. 4). Many patients experience recurrent pneumonia: (see Pneumomycosis) and epileptiform seizures; Possible damage to the liver and kidneys. The course of the disease is chronic with exacerbations. Most patients are exhausted, children lag behind in physical activity. development.

Candida panophthalmitis, iritis, endocarditis, etc. are observed.

Respiratory tract candidiasis can be primary or secondary. Damage to the pharynx and larynx is accompanied by attacks of dry cough, changes in voice timbre, laryngostenosis and sputum production. Candidal bronchitis is manifested by a persistent cough, mucopurulent sputum, and coarse wheezing. Primary yeast pneumonia often occurs during the treatment of some other disease with antibiotics, and secondary pneumonia can occur in patients with tuberculosis and occur as a complication of pneumonia of another etiology. Sometimes, due to the formation of cavities, mycotic pneumonia resembles tuberculous lesions of the lungs, which must always be taken into account when making a differential diagnosis (see Pneumomycosis). Sometimes it resembles pulmonary sarcoidosis.

Candidiasis of the digestive tract is manifested by various symptoms: decreased appetite, difficulty swallowing, vomiting with the release of cheesy films, liquid feces mixed with mucus, etc. As intestinal cancer progresses, dehydration of the body occurs, symptoms of intoxication and adynamia are expressed, and a febrile state may be observed.

Candidiasis of the urinary system is accompanied by the appearance of protein, blood and casts in the urine, and an abundance of fungal elements; the filtration capacity of the kidneys is impaired.

Secondary forms of candidiasis

Secondary forms of candidiasis (levurides, or mycids) occur in the presence of a primary focus in the internal organs, on the skin or mucous membranes, which sensitizes the body. Clinically, levurides appear as erythematosquamous, vesicular, parapsoriasiform or other elements. Secondary allergic rashes are usually symmetrical and may be accompanied by headache, malaise, cardiac dysfunction, and changes in the peripheral blood formula. Violations of the treatment regimen, irrational therapy, injury to K.'s foci or irritation of chemicals are of significant importance in the occurrence of levurides. substances.

Complications vary, but the most severe are septicopyemia and septicemia (see Sepsis).

What complications does thrush cause?

The key cause of complications is ignoring symptoms and self-medicating with home remedies.

Chronic thrush is characterized by the development of inflammation of the urethra and cervical canals, erosive lesions of the cervix, endometritis, and salpingoophoritis. Advanced candidiasis affects the reproductive function of the female body. The adhesive process progresses in the fallopian tubes. Adhesions prevent normal conception and cause ectopic pregnancy or infertility.

If you do not go to the clinic in a timely manner, thrush develops into visceral candidiasis, in which fungi affect internal organs:

• candidal cystitis and pyelocystitis;
• candidiasis of the gastrointestinal tract and oral cavity;
• bronchopulmonary candidiasis.

The penetration of candida into the systemic bloodstream causes candidal sepsis.

Consequences of candidiasis for pregnant women

Due to hormonal changes, the risk of fungal activation increases during the perinatal period, and therefore pregnant women are advised to consult a gynecologist. At Polyclinic +1, experienced doctors will talk about the manifestations of thrush in women and measures to prevent the disease. Neglecting treatment of vulvovaginal candidiasis threatens complications for the woman and the unborn child:

• spontaneous termination of pregnancy (miscarriage is typical for the first trimester);
• isthmic-cervical insufficiency (as a consequence - premature delivery).

Infection of an infant during delivery increases the risk of candidal stomatitis in newborns. In rare cases, fungi penetrate the placental barrier, causing intrauterine infection of the fetus.

Classification

Due to the wide variety of manifestations of K., many classifications have been proposed. However, according to the wedge, K.’s manifestations can be divided into four main groups.

A. Superficial Candidiasis:

1. Candidiasis of the mucous membranes: a) yeast stomatitis (thrush); b) yeast glossitis; c) candidal tonsillitis; d) vulvovaginal candidiasis; e) candidal balanitis and balanoposthitis.

2. Skin candidiasis: a) candidiasis; b) candidal cheilitis; c) Candidiasis of large skin folds (Intertriginous candidiasis, intertriginous yeast mycosis); d) interdigital candidal erosion of the hands; e) Candidiasis of small skin folds; f) other manifestations of smooth skin candidiasis. 3. Candidiasis of the nail folds and nails.

B. Chronic generalized (granulomatous) Candidiasis.

B. Visceral Candidiasis.

1. Candidiasis of the respiratory tract. 2. Candidiasis of the digestive tract. 3. Candidiasis of the urinary system.

D. Secondary (allergic) forms of candidiasis.

Diagnosis of thrush

Gynecologists at Polyclinic +1 will help differentiate candidiasis from other bacterial and sexually transmitted diseases. The qualifications of doctors and laboratory staff, and the clinic’s modern diagnostic equipment guarantee the reliability of studies of any complexity.

Diagnosis of thrush begins with a consultation with a gynecologist, which includes:

• collecting information about existing or past diseases, the nature of sexual life, methods of contraception used, the timing of the last menstruation;
• identification of characteristics of disturbing symptoms (duration, intensity, features, etc.);
• examination of a woman on a gynecological chair;
• recommendations and appointments.

Our doctors are attentive to women’s symptomatic complaints and history taking. Treatment tactics are determined taking into account hormonal status, age, and body characteristics.

Examination on a gynecological chair includes:

1. Visual assessment of the external condition of the genital mucosa (nonspecific discharge, hyperemia, rashes on the genitals).
2. Bimanual (two-handed) examination. Manipulation allows you to detect compactions, cysts, tumors, deviations in the size of the uterus and ovaries.
3. Instrumental examination using a gynecological speculum. Informs about erosive changes in the cervix and the condition of the genital organs.
4. Collection of biological material (smear) for laboratory research. A smear from the urethra and from the posterior vaginal fornix is ​​taken with disposable urogenital probes.

According to individual indications, it is possible to collect venous blood for enzyme immunoassay.

When collecting biomaterial at Polyclinic +1, sterility rules are observed and disposable consumables are used. The professional skills of our gynecologists ensure safety, absence of discomfort, pain during examination and taking a smear. The biological material is sent to the laboratory of our clinic.

Laboratory methods for diagnosing thrush

For laboratory determination of candidiasis, the clinic uses four modern diagnostic methods. The choice of a specific method depends on the clinical picture of the disease.

List of diagnostic methods:

1. Microscopy of a smear taken from the cervical canal, vagina and urethra. Does not quantify Candida albicans. Determines the presence and activity of conditional pathogens against the background of a sharp decrease in beneficial lactobacilli (less than 30%). Laboratory assistants at Polyclinic +1 perform microscopy in 20 minutes.
2. PCR (polymerase chain reaction). The method is based on determining the gene structure of microorganisms. The biomaterial is placed in a cycler (reactor), where Candida DNA molecules are split and genetic copies are completed using special reagents. PCR determines the type of candida and the number of microorganisms. The result is considered positive (infection detected) if the value exceeds > 1000 copies in the sample. Evaluation of the pathogen at the molecular level guarantees the accuracy of the result, which our laboratory provides within 24 hours.
3. Bacteriological culture. The analysis involves growing colonies of fungi on nutrient media. The laboratory container is filled with a medium favorable for the development of Candida, and a sample of the patient’s biomaterial is placed in it. During the study, qualified laboratory technicians evaluate the growth dynamics of microorganisms and the final number of colony-forming units (CFU). Norm of fungal mycelium: ≤ 10^4 CFU/ml. If the concentration is exceeded, the sensitivity of conditional pathogens to antifungal drugs is determined. Based on detected fungal resistance to drugs, a course of drug treatment is prescribed. Bacterial seeding is carried out within 5–7 days.
4. ELISA (enzyme-linked immunosorbent assay) of blood. Detects specific immunoglobulins IgG, IgA, IgM (antibodies), which the immune system produces in response to the activation of fungi. In a laboratory setting, a Candida specimen (antigen) is placed on a testing surface and the patient's blood is added to it. The reaction of the formation of antigen-antibody immune complexes determines the activity of fungi. The results are assessed by quality, quantity of antigens and immunoglobulin ratio. The analysis allows us to determine the degree of spread of microorganisms and the severity of the infectious and inflammatory process. The method is used if visceral candidiasis is suspected. The analysis is completed in 2–3 days.

Medical guarantees compliance with research deadlines and accuracy of results.

Symptoms of candidiasis

There are also several types of candida based on microbiological characteristics:

• Candida albicans is most widespread in Russia.
• Candida krusei
• Candida glabrata
• Candida tropicalis
• Candida parapsilosis

The genus of Candida must always be taken into account when prescribing treatment.

To determine the type of fungus, the severity of the inflammatory process, and the sensitivity of the pathogen to drugs, laboratory diagnostics are performed before prescribing treatment for candidiasis:

1. PCR analysis for candida is the determination of fungal DNA in cell scrapings or biological fluids. Material for analysis is taken depending on the expected area of ​​​​the lesion: In men - scraping from the head of the penis, from the urethra, prostate secretion, sperm.
2. In women, scraping of cells from the vestibule of the vagina, from the vagina itself, from the cervical canal.
3. Urine.
4. If the rectum is affected, scraping from the anal canal and feces.
5. If the process is in the oral cavity, upper respiratory tract - scraping from the mucous membrane of the cheeks, tongue, and pharynx. Saliva and sputum are collected.
6. The analysis can also be performed by taking material from the nasal mucosa, conjunctiva of the eye, and from erosive surfaces on the affected areas of the skin.
7. During the process on the nails, a part of the nail plate is taken.

This test for candidiasis has high sensitivity - up to 99%, speed of execution - 1 day, the ability to determine the amount of the pathogen, and low cost - 300 rubles. The material for the study is taken by a dermatovenerologist or gynecologist during the examination.

Treatment of thrush at Polyclinic +1

A comprehensive course of treatment for thrush in women is aimed at reducing fungal activity, restoring the balance of the vaginal microenvironment, and increasing immunity. The woman receives oral and local drug therapy.

The general treatment regimen includes several therapeutic areas:

1. Reduced number of fungal cells. Such treatment of thrush necessarily includes the use of fungicidal agents active against fungi of the genus Candida. The duration of antifungal therapy is determined by the doctor individually, depending on the severity of the clinical manifestations of thrush. Efficiency control is carried out using laboratory testing.
2. Normalization of the patient's health status. It is necessary to exclude exposure to factors that create favorable conditions for fungal infection. Medicinal and non-medicinal measures should be aimed at increasing the activity of the immune system, normalizing the metabolism and hormonal levels of the body.
3. Restoring normal microflora It is possible to cure thrush only after restoring the normal bacterial flora, which suppresses the activity of opportunistic fungi. Often candidiasis is a manifestation of vaginal dysbiosis. To normalize the microflora, preparations from the eubiotic group are used, which contain live bacteria, representatives of the normal flora. The duration of their use should not be less than 3 weeks.

To get rid of thrush, it is imperative to carry out diagnostics aimed at finding out the reasons for its development. The use of antimycotics (antifungal drugs) makes it possible to fight fungal infections. But, without eliminating the causative factors for the development of candidiasis, the result will be short-lived. Sooner or later, a relapse of thrush develops. It often occurs in women who self-medicated without consulting a doctor.

The complex of treatment measures includes:

• tablet preparations of the azole group - to suppress the systemic activity of candida;
• antifungal vaginal suppositories, ointments, creams with anti-inflammatory effects - for local destruction of fungi;
• oral, intravaginal eubiotics and probiotics - for the rehabilitation of vaginal microcenosis;
• immunomodulators - to restore, strengthen, maintain immunity.

Supportive therapy includes:

• diet correction;
• vaginal sanitation (procedures are carried out in our clinic).

Gynecologists at Polyclinic +1 develop a regimen for quick and effective treatment of thrush in women individually for each patient. For chronic candidiasis of the genital organs, a treatment plan is drawn up taking into account the duration of the disease.

Separate thrush treatment programs in our clinic are provided for pregnant women. Caring for the safety of the unborn child, the gynecologist selects antifungal medications that do not penetrate the placental barrier and are not absorbed into the systemic bloodstream. The dose of immunomodulators and probiotics is prescribed individually.

On a note! Our clinic provides services for the treatment of oral and intestinal candidiasis.

Vaginal sanitation procedures

Vaginal sanitation is aimed at cleansing the genitals and vaginal walls from accumulated leucorrhoea, relieving the symptoms of itching and burning, and increasing local immunity. For this we use:

• irrigation with antiseptic and anti-inflammatory solutions;
• treatment with vaginal probiotics, consisting mainly of lactobacilli;
• vaginal ozone therapy - douching with an ozonized solution, carried out under pressure using sterile instruments;
• wiping the genitals, tampons with ozonated oil;
• therapeutic vaginal baths.

Gynecologists at our clinic conduct therapeutic sessions without causing discomfort or pain to patients.

At the end of treatment, a smear is taken for a control analysis.

Diet for thrush

Changing your eating habits will help speed up treatment. The menu for thrush contains foods that prevent the growth of fungi and excludes foods that provoke candida activity.

Doctors at our clinic will help you develop a daily diet taking into account physical activity, age, and chronic diseases.

Prevention of thrush in women

Preventive measures consist of general recommendations and measures to prevent relapses.

General conditions for the prevention of thrush:

1. Observe personal hygiene rules. Change your underwear daily and toilet your genitals. Use your own towel. During menstruation, do not allow the pads to completely fill with blood discharge; change sanitary tampons every 3-4 hours.
2. Do not abuse antibacterial and antiseptic gels and soaps, so as not to disturb the vaginal microcenosis.
3. Refuse intimacy with a dubious partner.
4. Choose cotton underwear for daily wear.
5. Do not wear thongs every day (even in the summer season).
6. Limit consumption of simple carbohydrates (sweets). Enrich your diet with foods containing vitamins A, B, C and fermented milk products. Develop a balanced menu without bias towards proteins or carbohydrates.
7. Strengthen the immune system with regular physical exercise and seasonal intake of vitamin complexes for women.
8. Combine antibacterial therapy with prebiotics.
9. Visit a gynecologist every 6 months and at the first manifestation of unpleasant symptoms.

We recommend that women consult a gynecologist at our clinic “Polyclinic +1” and get tested for thrush when planning a pregnancy.

To prevent relapses, our gynecologists prescribe a single monthly dose of fungicidal medications, as well as medications to strengthen the immune system.

Joint treatment will help completely eliminate thrush. Doctors draw up a course therapy plan for the sexual partner. Candidal urethritis in men is treated by experienced venereologists at Polyclinic +1.

Diagnosis and treatment

An accurate diagnosis can only be obtained after a medical examination. At home, you can independently recognize thrush by its cheesy white discharge.

To identify concomitant infections, swabs are taken from the vagina and urethra.

An infectious disease can be cured with the help of special antifungal medications, for example, by purchasing pimafucin. Usually the drugs are produced in the form of rectal and vaginal suppositories. Also available in the form of creams for local application and tablets for oral administration.

Many fungi become resistant to drugs. In the initial stages of infection, it is better to use creams and suppositories.

For preventive purposes, you should adhere to the following useful tips:

• follow a diet;
• drink as little tea and coffee as possible (at the time of treatment);
• strengthen the immune system, take vitamins;
• get more sleep (7-8 hours);
• maintain personal hygiene;
• avoid hypothermia;
• do not eat food after others;
• avoid stress and depression.

With complications, diseases of other internal organs may appear. In its most severe forms, candidiasis can even affect the brain. But usually the fungus does not pose a serious threat to life.

"Polyclinic +1" is the best choice

Taking care of the health and comfort of patients, we guarantee:

• sterility of biomaterial collection;
• efficiency, punctuality of diagnosis;
• exemplary quality of therapy;
• professionalism of doctors and laboratory technicians;
• personal selection of diagnostic methods and therapeutic treatment regimens;
• individual treatment plan during pregnancy;
• attention and friendliness of the staff;
• anonymity of tests, consultations, treatment;
• compliance with medical legislation;
• relevance of licenses and certificates.

We work seven days a week. Appointments can be made at a time convenient for patients by phone or on the Polyclinic +1 website. The clinic is located in the center of Moscow. There is parking nearby. Contact us - we will help maintain your health!

Treatment of chronic candidiasis

In the chronic course of thrush, the volume of vaginal discharge is reduced. White films, dry erosions, and whitish scales (lichenification) form on the surface of the genitals. The vulvar mucosa becomes flabby, swollen, and acquires a brown tint. The entrance to the vagina narrows. The spread of the inflammatory process to the internal genital organs causes candidal cervicitis, urethritis, menstrual irregularities, and groin pain. The relapse period is characterized by an increase in acute symptoms.

Why is it necessary to treat chronic candidiasis?

Chronic candidiasis in women threatens a number of unpleasant consequences. The infection spreads to the bladder and kidneys. The cervix is ​​involved in the inflammatory process, which is fraught with erosion. Streptococci and staphylococci enter the body through scratched areas of the skin and mucous membranes.

In a pregnant woman, the disease can cause miscarriage and premature birth. In addition, during birth, the child may get candidiasis of the oral cavity and mucous membranes of the eyes.

How is chronic candidiasis treated in our clinic?

Gynecologists V.S. Rigas and R.A. Sasunova have extensive experience. They are fluent in the treatment of chronic candidiasis. To accurately diagnose and exclude STDs, doctors prescribe laboratory tests for syphilis, HIV, hepatitis B and C, and conduct a gynecological examination.

You will be prescribed effective antifungal drugs that will quickly cope with the infection. In addition, according to individual indications, the doctor will prescribe medications to strengthen the immune system, eliminate hormonal imbalances and normalize metabolism. Doctors monitor the treatment process and monitor the dynamics of improvement.

How does candidiasis manifest?

The manifestations of this infectious disease are 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.

Candidiasis of hair follicles is not common. 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 externally manifests itself in the formation of a dense white coating, after removal of which erosion forms. 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 in the genitourinary organs is a 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.

Candidiasis during pregnancy

Pregnant women experience significant changes in their bodies, which primarily relate to metabolism and hormonal levels.

They sometimes contribute to the activation of opportunistic microflora, in particular, yeast fungi of the genus Candida.

This occurs due to the fact that the number of fungal cells increases against the background of changes in metabolic processes (physiological increase in sugar levels) and hormonal levels (prevalence of progesterone levels necessary to maintain the normal course of pregnancy).

Activation of a fungal infection leads to the development of candidiasis (thrush) with a predominant localization of the infectious process in the vaginal mucosa of a pregnant woman.

Symptoms of thrush during pregnancy

1. inflammatory manifestations;
2. itching;
3. burning sensation in the vagina;
4. white cheesy discharge and plaque.

Thrush in early pregnancy significantly reduces the activity of the immune system and changes the normal microflora of the vagina.

This can subsequently have a negative impact on the normal course of pregnancy, intrauterine development of the fetus and childbirth.

Diagnosis of thrush

It is not difficult to suspect the development of thrush, since it manifests itself with characteristic clinical symptoms.

To clarify the causes and predisposing factors that provoke the development of the infectious process, additional research may be carried out, including:

• determination of the number of fungal cells using culture or PCR;
• determination of hormone levels in the blood;
• assessment of the activity of the immune system.

This is necessary for choosing the optimal therapeutic tactics for subsequent treatment of thrush.

Treatment of thrush during pregnancy

• Reducing the activity of fungal infection with antifungal drugs for external use. The doctor must choose medications that are not absorbed into the systemic bloodstream and do not penetrate the placental barrier into the body of the developing fetus.
• Improving the state of normal microflora with the help of eubiotic preparations that contain living microorganisms.

Therapeutic measures during pregnancy are complex. They must be carried out taking into account the need for safety for the developing fetus.

The inclusion of means to normalize the activity of the immune system and metabolism is possible only for strict medical reasons.

You can take any of the venereological tests and receive treatment for candidiasis at the Polyclinic +1 clinic.

Oral candidiasis

Oral candidiasis is inflammatory changes in the oral cavity and pharynx that occur against the background of excessive growth of saprophytic yeast fungi of the genus Candida.

It is not at all necessary that mushrooms enter the oral cavity as a result of dubious sexual contacts.

Quite often, candidiasis becomes the result of dysbiosis of the oropharynx during antibacterial treatment or immunodeficiency.

Patients receiving inhaled glucocorticoids (for example, for bronchial asthma) often suffer from candidiasis if primary prevention measures for fungal overgrowth (soda or other alkaline mouth rinses) are not followed.

Overuse of antibacterial toothpastes and mouthwashes can also lead to increased fungal growth.

Thrush on the tongue is an inflammatory fungal change in the tongue, usually represented by a white or grayish dense coating and enlarged taste buds.

Often combined with aphthous stomatitis, erosions of the oral mucosa and gums. Erosive processes cause pain, make eating difficult and can cause increased bleeding.

Often the tongue becomes covered with quite deep and painful cracks.

Throat candidiasis - changes in the pharynx (pharyngitis) with typical erosive and inflammatory processes and pain when swallowing, enlargement and ulceration of the tonsils.

Such candidiasis must be differentiated from diphtheria, in which dense whitish filmy deposits in the throat are also typical.

Often, with candidal pharyngitis, the submandibular lymph nodes also react, which become enlarged and painful.

Lesions of the larynx and ligamentous apparatus are primarily manifested by hoarseness and sore throat.

Treatment of oral candidiasis

Treatment begins with local remedies: alkaline rinses, treatment of the mucous membrane with antifungal ointments or gels. Plaque can be removed forcibly with sterile wipes with soda solution or furatsilin.

In case of a widespread process or its persistent course, they resort to systemic antifungal agents (azoles or antibiotics).

An important part is strengthening the body's immune response. Also, for pain relief you have to use local anesthetics in gels. Healing of mucous membranes is stimulated by rinsing with rotokan and salvin.

Candidiasis of the gastrointestinal tract (GIT)

Candidiasis of the gastrointestinal tract (GIT) is a disease that is by no means uncommon.

Activation of Candida (an infectious agent belonging to the opportunistic flora of the mucous membranes) is caused by:

• decreased immune activity;
• poor nutrition;
• metabolic disorders with increased blood sugar levels;
• long-term use of antibiotics.

Candidiasis of the gastrointestinal tract - intestines, stomach or esophagus, requires measures. They are aimed at reducing the number of fungal cells and eliminating the effects of provoking factors.

Candidiasis on the mucous membrane of the esophagus leads to the development of an inflammatory process with a feeling of discomfort behind the sternum and swallowing disorders (dysphagia).

Sometimes the disease can occur without symptoms.

To make a diagnosis, esophagoscopy is performed. With its help, redness (hyperemia) of the mucous membrane and the appearance of cheesy white deposits on it are determined.

Localization of the infectious process in the stomach is accompanied by pain and heaviness in the upper abdomen, and decreased appetite.

When examining the gastric mucosa during gastroscopy, hyperemia and cheesy white deposits are determined.

Complications of candidiasis

• Ulceration of the mucous membranes and skin with the formation of fistulas and rough scars.
• Tissue ruptures in the folds of the skin, corners of the mouth, in the vestibule of the vagina, foreskin.
• Narrowing of the opening of the foreskin with the formation of phimosis - the inability to open the head, or paraphimosis - pinching of the head.
• Development of chronic urethritis, prostatitis.
• Damage to the uterus, fallopian tubes and ovaries with the formation of infertility.
• The appearance of allergic reactions on the skin.
• Loss of vision.
• Severe damage to the lungs, intestines and other internal organs.

Despite the fact that candida is a component of normal microflora on human mucous membranes, in certain situations it can manifest itself as a pathogenic microorganism, causing serious diseases and complications.

Treatment of candidiasis should only be carried out by a qualified dermatovenerologist, mycologist or gynecologist using all methods of systemic and local therapy.

Intestinal candidiasis

With the activation of infection caused by fungi of the genus Candida, which belong to the opportunistic flora, intestinal candidiasis develops on the mucous membrane of the digestive tract.

This is a fairly common pathology, which can be accompanied by dysbacteriosis (disturbance in the composition of normal microflora).

In small quantities, microscopic Candida fungi are constantly present on the mucous membrane of the digestive tract.

When exposed to provoking factors, fungi are activated and inflammation develops.

Causes of intestinal candidiasis:

• decreased immune activity;
• metabolic disorders;
• poor nutrition;
• long-term antibiotic therapy.

Thrush in the intestines is characterized by the development of nagging pain and a feeling of heaviness in the abdomen and bloating.

Then there is a weakening of the stool, in which streaks of mucus and white cheesy inclusions appear.

There may be a feeling of incomplete bowel movement after bowel movements.

Treatment of intestinal candidiasis

Therapy is complex. At the initial stage, the number of fungal cells is reduced using antifungal drugs in the form of tablets or capsules.

Then probiotics are included in the therapy to restore the microflora.

You can take any of the tests for candidiasis and receive treatment for candidiasis at the Polyclinic +1 clinic.

Why does the disease occur?

In small 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.

Various reasons can lead to a decrease in immunity. 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 gastrointestinal pathologies, diabetes mellitus.

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