candidiasis Defination candida albican may cause different types

念珠菌病 candidiasis

一．Defination candida albican may cause different types of lesions of the skin, nails, mucous membranes , and viscera, which is called candidiasis normal inhabitant conditioned pathogen, ( autogenous infection ) (1) hypoimmunity (2) local surrounding changed. (3) Antibiotic, immunity inhibiter, etc. .

二．Etiopathogenisis Candida albican is the commonest algogen and its virulence is the strongest. normal inhabitant(spore): 1. cell immunity ↓ primary infection: the phagocytosis of neutrophil decreased. Lack of myeloperoxidase and aggregation factors. Second infection: blood glucose↑, Vit. A ↓, AIDS.

Iatrogenic factors: using broad-spectrum antibiotic, adrenal cortex hormone, immunity inhibiter, radiotherapy and chems. Spore hypha Aherence of cell well ↑ The ability of resistence of phagocytosis↑ The production of toxin

三． Clinical apparence : （一） mucocutaneous candidiasis （二） systemic candidiasis （三） disseminated candidiasis

1. thrush l grayish white membrane plaques are found on the surface of the oral mucous membrane, gingival, tongue.

2． Candidal vulvovaginitis ： • white color pseudomembrane • fluor albus↑(cheese, bean dregs secretion) • the cunnus is erythematous and pruritic. • Pregnancy and DM are prone to develop disease. • Pseudohypha and clumped germ.

3. Candida balanitis （1）Glans and coronary sulcus are susceptible. （2）Erythema, superficial erosion pseudomembrane （3）Apparent pruritus （4）over-long acrobystia and DM are susceptible. （5） Pseudohypha and clumped germ.

4. Candida fingerweb erosion：related to fatness , occupation etc.

5． Candidal intertrigo 〈1〉Child or obesity. 〈2〉 The folds of the body. 〈3〉 Erubescence, erosion, effusion and incrustation. 〈4〉 Erythraeous papule, desquamation

6． Popular candidiasis • obesity • Chest-back, perineum • Flat dark red papule • With clear boundary and albicans ring scale. • Pruritus.

7． Candidal paronychia and onychitis： Involving finger nail. red swelling nail groove, epinephelus nail plate with white spotting.

8．Chronic mucocutaneous candidiasis • With cryptorrheic or immunocopromised disease. • Childhood • Heredity • verrucous hyperplasia with dirty and thick crust.

mucocutaneous candidiasis

Systemic candidiasis 〈一〉Candia albicans can infect many organs , including alimentary canal, respiratory apparatus, urinary system, endocardium and meninges. 〈二〉 susceptible population: DM, malignant tumor, leukemia, AIDS 〈三〉 susceptible factors: using the long-time , broad-spectrum antibioticm and corticosteroids; radiotherapy; chemo.

disseminated candidiasis 1 involving many systems at the same time 2 candidal septicemia 3 bad prognosis.

四． Diagnosis and differential diagnosis All kinds of clinical appearances and fungi tests(pseudohypha germ and hypha→pathopoiesis)

五 prevention and cure tropical treatment: mucocutaeous type 1． 2％clotrimazole cream , miconazole cream. compound resorcinol liniment+ power 2 ． nystatin 100, 000 u + camphor sulphur calamina lotion 100 ml nystatin suspl. ( nystatin 100, 000 u+ glycerol 20 ml+ distilled water 80 ml) 3． nystatin suppository(5000 -10, 000 u)qn. X 1 -2 w

（二） oral medication ： Systemic and disseminated candidiasis or primary candidiasis 1． ketoconazole 0. 2 qd, vaginitis 5 -10 d. 2． nystatin 200, 000 -400, 000 u qd X 1 w(alimentary canal) 3． polyaldehyde nystatin 50, 000 u +NS 5 ml → air duct inhalation 4． amphotericin. B 5 mg + aqua pro injectione 20 ml → 5 ml inhalator Bid –qid.

5． Amphotericin. B 0. 5 -1 mg/kg/d intravenous drip or 5 -flucytosine 2 -3 g/d by mouth 6． Fluconazol: 50 -100 mg/d, course of treatment according to pathogenetic condition 7. Itraconazole 0. 2 g/d course of treatment according to pathogenetic condition 8. Take-down cause of a disease and preservation