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Candidiasis

 
 


This infection is caused by yeast like fungus- candida, found everywhere in the environment. Candida also lives in healthy human beings in superficial, soft, moist areas and openings like oral cavity, G.I. Tract, over skin; mucocutaneous junctions i.e. lips, anus, vagina, Penile or genital areas. It lives along with native bacteria which prevent its overgrowth. Candida overgrowth is also checked by the human defense mechanism. In immune compromised patients like AIDS and Diabetes etc. Candidiasis is very common.

Different types of Candidiasis infection-

Cutaneous Candidiasis - Candida can cause skin infections in areas which are not well aerated and remain moist with sweat or urine or any other discharge i.e. diaper rash, in the crease of the buttocks, around the groin and the skin folds under female breasts. Cutaneous candidiasis causes patches of red, watery discharging lesions with small vesicles surrounding it. This skin infection can be treated with antifungal powders and creams.

Thrush, Oropharyngeal or Oral Candidiasis - presents as thick white patches in the mouth on the tongue, the palate or the lips. The symptoms are dry mouth, altered taste or difficulty in swallowing. Attempt to remove these patches can cause bleeding. For treating these patches, topical antifungal medications such as nystatin or clotrimazole lozenge can be dissolved in the mouth. For more severe cases fluconazole can be taken once a day orally (by mouth). Amphotericin B is available in a liquid form for the treatment of oral candidiasis. The usual dose is 100 mg a day, four times a day. In older times a coal tar dye - gentian violet, was used topically in the oral cavity and other sites but it used to discolor the site and clothes.


Esophagitis or Esophageal Candidiasis causes difficulty in swallowing and chest pain that centers behind the sternum. Candida esophagitis is treated with itraconazole (FUNGITRACE®)

Vaginal Candidiasis or Vaginal yeast infections - Genital candidiasis can cause simple vaginal itch to burning in and around the vagina, or cause a thick white vaginal discharge and discomfort during sexual intercourse. Vaginal yeast infections can be treated with tablets, creams, ointments or suppositories directly administered into the vagina. These medications include clotrimazole, miconazole, nystatin, tioconazole and terconazole. Oral short course of itraconazole (FUNGITRACE®) or fluconazole is given in severe cases.

Invasive or Systemic Candidiasis - Deep candidiasis or candida sepsis are serious types of general infection where candida enters the blood stream through the skin or catheters or tubes in the body of immune compromised patients i.e. premature and low birth weight babies, AIDS patients, burn cases, diabetics and in other serious medical problems and the patient gets disseminated candidiasis. Candida sepsis causes fever which does not respond to broad spectrum antibiotics, if not diagnosed in time it may cause shock and multiple organ failure.

Treatment
Resistance to the "azole" drugs is quite common for Candida and most of the times the infection is so severe that it cannot be adequately treated with azoles. Amphotericine B is the only effective treatment of invasive candidiasis. But because of life threatening nephrotoxity and infusion toxicities of Amphotericin B its nephro-safe formula liposomal Amphotericin B (FUNGISOME) is the Gold Standard treatment for invasive candidiasis.
 

 
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