Monday, October 18, 2021

Treat yeast infection

 Treat yeast infection

What is it
Candidiasis is the infection caused by a type of fungus known as candida and can affect different parts of the body . “If the candidiasis is oral, we know it as thrush, causing inflammation of the esophagus if it spreads to this area. There are also vaginal and genital yeast infections, as well as yeast infections of the skin, creating a rash and itching. If candidiasis spreads to the blood, it is more dangerous ”, explains Carmen Navas, gynecologist at the Vithas la Salud Hospital (Granada) .


They are part of the group of the most frequent diseases and it can even be said that practically all people throughout their lives will suffer from it at some time. There are three types of human mycoses : superficial, intermediate - such as candidiasis - and deep. The usual ones in Spain are superficial and candidiasis. In this section we will discuss mucocutaneous candidiasis , the pathogen of which is Candida albicans .

Causes
Most candida species are saprophytic and can form part of the skin flora,  with the exception of Candida albicans , which when found on the skin is the etiological agent of a primary candidiasis. There are multiple predisposing factors for candidal infection: some depend on the host and others on environmental conditions.

Among the first are the physiological , genetic and acquired . Thus, newborns, women in the premenstrual period or pregnant, patients with Down syndrome , diabetes , lymphoma , leukemia , who take antibiotics or corticosteroids or immunosuppressants or suffer from debilitating diseases, have greater facility to suffer this dermatosis. Among the environmental factors, they favor infestation: humidity, heat, chronic maceration (for example, of the corners in the elderly), poorly fitting dental prostheses and friction between two skin surfaces.

Navas exposes the causes schematically:

  • Situations that alter the protective intestinal or genital flora, such as prolonged intake of antibiotics.
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  • Situations that increase the amount of glucose in the blood: diabetes, overweight, obesity , excessive intake of alcohol or carbohydrates .
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  • Excessive and prolonged humidity.
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  • Situations that decrease the function of the immune system: human immunodeficiency virus (HIV) , transplants, chemotherapy, etc.
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  • Use of underwear made of synthetic materials.
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  • Hormonal changes in situations of pregnancy or hormonal contraception.


Symptoms
Symptoms vary depending on the location. From a dermatological point of view, mucosal and cutaneous candidiasis are of interest. Within the first and affecting the mucosa is thrush . This manifests as creamy and whitish plaques that converge on the back of the tongue, soft palate, gingival and genital mucosa. When detached, they reveal a red and congestive mucosa. The infection can also manifest as a red, smooth, shiny and painful tongue or as an involvement of the mouth corners in the form of triangular plates, with scales and fissures in the center or affecting the lips, mainly the lower one with adherent colored scales. grayish and erosions.

The genito-perianal mucosa is another common location for these infections, representing 20-30% of vaginal infections. It presents as a redness and edema of the labia minora that can extend to the labia majora, perineum, inguinal and intergluteal folds, accompanied by itching and "burning." The same affectation can affect male external genitalia. Within cutaneous candidiasis we are going to refer to two pictures: candidiasis of the folds or candidiasic intertrigos and onychomycosis .

In summary, Navas points out that candidiasis usually presents with redness, a cluster of thick whitish discharge, a burning or itching sensation, and sometimes inflammation and pain.

Prevention
If prolonged intake of antibiotics is necessary , it is recommended during or after treatment to take intestinal probiotics and intimate flora to control the excess growth of candida.
 
Changes in diet with reduced intake of alcohol, sugars and carbohydrates.
 
Adequate glycemic control in diabetic patients.
 
Avoid prolonged humidity , making an adequate drying after swimming in the pool and the sea.
 
Using underwear more natural materials and avoid excessively tight clothing.
 
Maintaining good hygiene usually prevents bouts of yeast infection. It is important to dry the skin folds well once you get out of the shower, as well as to brush your teeth and use oral fluoride mouthwashes.
 
The snuff be avoided.
 
To avoid candidiasis in the genital area , condoms can be used to prevent contact. In the case of pregnant women, it is also recommended to take bioactive yogurts to promote the acidity of the vaginal flora.

Types
Candidate intertrigos
It is the most frequent clinical form. It can affect large folds such as armpits, groin, intergluteal fold, submammary region, lateral face of the neck or small folds such as interdigital spaces of the hands, feet and retroauricular region. The skin is reddened, slightly edematous, and there may be vesicular-pustular elements on the surface. It is very typical to observe how these areas are delimited by a thin scaly rim, appearing satellite lesions. The patient reports severe itching and burning.

Candida onychomycosis
Candida onychomycosis, which affects the fingernails or toenails, appears with some frequency in children with thrush and in adults with intertrigo of small interdigital folds . It can appear as a painful inflammation of the periungual ridge, accompanied by minimal purulent discharge, or as a thickening of the nail plate with pinpoint depressions and transverse grooves.

Candidiasis in the digestive system

Esophageal: there  is an inflammation that causes swallowing problems, burning and pain in the chest.
 
Candida gastritis: it  appears, above all, in those patients who suffer from gastric ulcer.
 
Candida enteritis:  causes abdominal pain and stools more frequently, which may contain threads of blood, leading to dehydration from diarrhea . It is difficult to diagnose.
 
Candida anitis: causes  itching, stinging and irritation of the anus.

Candidiasis in the respiratory system
Candidal laryngitis can occur, which is usually caused by an oral thrush. The thrush plaques travel to the respiratory system, affecting the bronchi and causing frequent coughs, fever, and bloody sputum.

Candidiasis in the reproductive system
Candida vulvovaginitis: it  appears due to an alteration of the vaginal pH, especially in pregnant women. Causes irritation and itching in the vagina.
 
Candida Balanitis :  causes infection in the glans and foreskin of the penis , which gives rise to itchy pustules.

Diagnosis
The diagnosis is fundamentally clinical ,  although sometimes it is necessary to rely on a direct examination of the scales or on a mycological culture.

Navas specifies that the diagnosis must always be made by swab culture on the affected area and sending the sample to a microbiology laboratory to confirm the presence of candida colonies. If candida is suspected in the blood, a blood sample is sent for culture.

Treatments
There are different types of antifungal drugs , but the most commonly used are in the azole family and can be used topically (eggs and creams) and orally in pills. Examples of these drugs are: clotrimazole, fluconazole, itraconazole, and ketoconazole.

“Today we know that to avoid frequent relapses and the repetition of symptoms after taking antifungal therapy, it is important to complete with a probiotic treatment that improves our protective flora . This treatment sometimes has to be repeated for about three months ”, adds Navas.

Other data
Forecast
The prognosis of candidiasis that affects the skin and mucous membranes is very good because it responds very well to the treatments that we know as antifungals. However, the prognosis is more reserved in the case of patients with an altered immune system due to some disease such as HIV, transplants or chemotherapy treatments. In these cases, the candida can pass into the blood and create more serious infections.

Candidiasis in men
Although it is more common in women, yeast infection can also affect men. In particular, men can suffer from candida balanitis or inflammation of the glans penis. They will notice wetter penile skin, thick white discharge in the folds, redness, itching, or a burning sensation. The candidiasis in men is more common in men with diabetes, overweight, if you have taken antibiotics continuously with phimosis , if you have your immune system altered by disease or some general hygiene practices are not correct.

Male yeast infections are common because the fungus that causes them (candida) is present on the skin, especially if it is wet. The infection can occur when the candida overgrowth by some factor that contributes to it , for example, having sex with a woman with vaginal yeast infection.

Most male yeast infections are easily treated with antifungal medications . An important aspect for its cure is that if a man and his partner have the same symptoms of candidiasis, both should receive treatment to prevent the contagion between them again.
Pregnancy
Genital candidiasis is frequent in pregnant women due to changes in vaginal pH that are produced by hormonal changes, and the increase in humidity due to increased flow. Topical treatments, such as creams and ovules, can be used safely in pregnancy, but it is always recommended to consult with the specialist in Gynecology before doing so.

Candidiasis in the infant
Candidiasis in infants is characterized by redness, irritation, and discomfort of the skin in the diaper area, similar to a contact dermatitis or diaper rash . This condition could also have been contracted during childbirth.

This variant of candidiasis is treated, initially, with conservative measures (increased frequency of diaper changes, use of highly absorbent diapers and more careful hygiene of the area) and application of antifungal creams such as imidazole.

If the infant has oral candidiasis, it is treated with topical oral solutions with another antifungal, nystatin. This therapy is also used in oral or oropharyngeal candidiasis in adults.

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