Severe visceral forms of candidiasis and candidasepsis often begin with oral candidiasis in adults; therefore, special attention is now paid to the diagnosis and treatment of fungal diseases of the oral mucosa.
The factors causing infection with candidiasis and its forms:
Yeast-like anaerobic fungi of the Candida genus, which easily adapt and grow well in conditions of limited nutrition, cause x-ray and laser radiation, freezing and drying.
More than 80 species of Candida mushrooms are known. Most of them are safe and only a few cause candidal infection . The most pathogenic species are C. albicans and C. Tropicalis. When a defect occurs in the body's defense system, the mushrooms begin to actively proliferate and invade epithelial cells.
The factors that induce oral candidiasis are:
- Mechanical and chemical microtraumas (carious teeth, dentures, irrational medical tactics during the rehabilitation);
- Antibiotics and some other substances used in the production of canned food and food on mucous membranes and skin;
- Metabolic disorders (iron deficiency, hypovitaminosis, endocrine pathologies, ovarian hypofunction, hypothyroidism);
- Somatic diseases that reduce the body's resistance (immunity disorders, gastrointestinal diseases, gynecological pathology, etc.);
- Candidate ;
- Secondary immunodeficiency states;
- Unsystematic antibiotic treatment.
The main symptoms of damage to the oral cavity and the red border of the lips (they are observed in 41.7% of patients with candidal pathology) are mucosal hyperemia, plaque, desquamation and puffiness. These symptoms are observed in any form of candidiasis: acute pseudomembranous candidiasis, acute atrophic candidiasis, chronic hyperplastic candidiasis, chronic atrophic candidiasis.
These forms are isolated on the basis of the clinical course. Localized candidiasis of the oral cavity are divided into stomatitis , glossitis and cheilitis, gums, gingivitis, etc.
Acute Pseudomembranous Candidiasis
The most common form of candidiasis, which occurs even in newborns, infants, weakened by bronchitis and infectious diseases. In adulthood, the so-called "thrush" occurs in cancer.
Scope: tongue, sky, cheeks.
Complaints of patients: dry mouth, pain when eating, burning.
Clinical manifestations: plaque in the form of a curd film, which, with mild illness, is easily removed. Under the bloom an edematous, hyperemic surface is found. If candidiasis is triggered, then bleeding erosion is detected under a difficult-to-remove film.
Stage of the disease:
- desquamative (areas of desquamation on the back of the tongue, the plaque is difficult to remove);
- erythematous (tongue edematous, viscous, foamy);
- infiltrative (difficult to remove bloom covered lateral surfaces of the tongue);
- erosive (loose, gray-white coating, after removal, erosion is detected).
Click on the spoiler below to see what candidiasis looks in your mouth:
Acute atrophic candidiasis
Arises both independently and after acute pseudomembranous form.
The main cause of occurrence is a side effect from taking antibacterial drugs, inhaled corticosteroids.
Complaints of patients: dryness and burning sensation in the oral cavity, the inability to move the tongue, the sensitivity of the mucous to any irritants.
Clinical manifestations: erythema spots without plaque or with bloom in large folds of the tongue, fiery-red color of the mucous membrane, the back of the tongue (when it is involved in the infection) is dark red, shiny, mucous cheeks and lips border thinned, sometimes crusts appear on lips.
Chronic hyperplastic candidiasis
It occurs in 75% of patients. The main contingent is people who take cytostatics, antibiotics, those who have a history of tuberculosis and blood diseases. Sometimes diagnosed in smokers and patients using dentures.
Complaints of patients: the perversion of taste, pain when taking spicy and acidic foods, dry mouth.
Clinical manifestations: the mucous is hyperemic, white plaques of various sizes can appear on the tongue and cheeks. In advanced cases, a rough, whitish-gray bloom occurs, which is removed with difficulty. Under bloom, bleeding erosion is detected. If the tongue is affected, nipple growth may occur.
Chronic atrophic candidiasis
It is diagnosed in patients with dentures, the elderly, with comorbid conditions: atrophic gastritis, diabetes, etc.
Complaints of patients: dryness and burning of the mucous membrane, redness, the release of viscous, sticky saliva.
Candidiasis of this form often affects the shell of the prosthetic bed, and in most cases these are upper jaw prostheses. Long-term current disease can cause atrophy of the papillary apparatus of the tongue.
Each of the above forms may be accompanied (or may occur independently) by mycotic diseases, candidal cheilitis and candidal gingivitis.
Mycotic zaeda, or candidiasis of the corners of the mouth, is a disease that is diagnosed in children who have the habit of sucking their finger or licking their lips, in adults with low bite. The main signs of zaeda are cracks in the corners of the mouth, erythema and easily removed whitish patina.
Candida cheilitis is a disease in which the red rim of the lips is affected. Often, cheilitis affects the lower lip: first, individual bubbles appear on it, eventually merging into a white film. For cheilitis is characterized by severe itching, aggravated at night and a feeling of tightness.
If you do not treat candidiasis of the oral mucosa and the corners of the mouth, there are discomfort in the abdomen, headache and bad breath start to disturb, nausea and irritability occur. The pathological effect of fungi on the body is explained by the production of a number of toxic substances by microorganisms, the long-term cumulation of which disrupts the vegetative nervous system.
A fundamental point in the treatment is drug antifungal therapy , which can be systemic and local. Preparations for local treatment are divided into antimycotics and antiseptics.
In western Europe and the CIS countries, the most commonly prescribed drugs are Miramistin, Cetylpyridinium Chloride, Triclosan, Chlorhexidine Bigluconate, Hexetidine, Sanguirythrin. Some of these antiseptics, in addition to weakening the pathogenic properties of fungi and helping to reduce the contamination of the oral cavity by fungi, also suppress inflammatory phenomena.
Table "Drugs for the treatment of fungal infections of the oral cavity and the corners of the mouth":
|A drug||Assignment scheme|
|Tantum Verde (spray, solution, lozenges)|| Spray: 4-8 times a day for adults, every 1.5-3 hours, children 6-12 years old 4 times a day, up to 6 years - at the rate of 1 dose for every 4 kg of body weight.
Solution: 1 tablespoon (15 ml) of mouthwash or throat every 1.5-3 hours.
Tablets: one 3-4 times a day.
|Novosept forte (spray, lozenges)||1 lozenge for sucking every 2-3 hours, spray irrigate mucous 3-4 times a day|
|Lugol solution||Irrigation 3-4 times a day, mucous applications|
|Chlorhexidine digluconate||6-8 rinses for 1 minute (10 ml.)|
|Sanguirythrine||2-3 irrigations per day|
|Oralcept||The drug is sprayed into the oral cavity every 4-6 hours.|
|Aqueous solutions of aniline dyes||3-4 times a day, duration 1-2 weeks (you can swallow and simultaneously sanitize the esophagus from mushrooms )|
|Fukortsin , brilliant green and fuchsin||Applied to the treatment of mycotic jasper.|
|Kanesten (cream)||Applications 2-3 times a day|
|Nystatin (ointment or water suspension)||4 applications a day for 30 minutes, rinses for 1 min. (at one time 5-10 ml.)|
|Amphotericin||Rinse and application 4 times a day for 1 ml.|
|Clotrimazole (spray)||Irrigation mucous|
|Candide or Clotrimazole 1% oral solution||Check with the pharmacy before buying - special solutions are available that can rinse your mouth.|
|Antimycotics for systemic therapy|
|Fluconazole||50-100 mg. per day (duration - 10 days)|
|Itraconazole||100-200 mg. per day (duration 7 - 10 days)|
|Ketoconazole||200-400 mg. per day (duration - a maximum of 10 days)|
|Nizoral||10-14 days once a day in the morning during the meal at a dose of 200 mg. (control on liver and kidney functions is required)|
|Diflucan||10-14 days at a dose of 50 to 200 mg. in the morning|
|Orungal||15 days per capsule per day after a full meal|
During the treatment of oral candidiasis, concomitant diseases are necessarily treated. In addition, the reception is important:
- Drugs that normalize the intestinal microbial flora;
- Drugs with immunocorrective action;
- Restorative remedies;
- Medication, relieving inflammation and contributing to the restoration of the epithelium.
Drug therapy of oral candidiasis and the corners of the mouth should be combined with electrophoresis, phonophoresis, quartz therapy. Facilitates the course of candidiasis and relieves the inflammatory reactions of phytotherapy (the oral cavity is irrigated with broths of medicinal herbs - yarrow , sage, chamomile, and St. John's wort ).
As you can see, the arsenal of antifungal agents is very impressive. However, candidiasis is an insidious disease, and the therapeutic effect of treatment is not always observed. In addition, there is often a relapse of a yeast infection .
Therefore, do not self-medicate. A specialist (dentist, ENT, or, in extreme cases, a therapist) will prescribe treatment, take into account general somatic pathology and select rational in your particular case preparations.