Fungi of the genus Candida are normal components of intestinal microflora and the human oral cavity. When sowing feces, they are detected in about half of the healthy with a single study, and in the study of crops from the oral cavity — in 1/3.
In all forms of systemic candidiasis — against the background of massive antibiotic therapy, chemotherapy of malignant tumors, extensive injuries, burns, AIDS – the source of the spread of fungi is the gastrointestinal tract
In the gastrointestinal tract and on the mucous membranes of the genital organs, excessive growth of Candida albicans causes “chronic candidiasis syndrome”. It is similar to chronic fatigue syndrome, except for exacerbation of flu-like symptoms. In a certain number of patients with chronic fatigue syndrome, effective treatment with antifungal therapy and a diet that prevents the excessive growth of Candida-type fungi is Possible, the mechanism of this effect is due to the fact that C. albicans inhibits the function of mucosal T— and NK-cells, as well as herpes viruses, cytomegaly and Epstein-Barr in chronic fatigue syndrome. It is the reactivation of herpes viruses in the body and causes recurrence of flu-like symptoms.
MECHANISMS OF DEVELOPMENT AND DISEASE
To provide a mechanism for the development of candidiasis can in the following diagram. The biotope of the intestine with a normal content of C. Albicans, which is < 104, is infected with pathogenic strains, intracellular selection with pathogenic strains, or an increase in the number of C. albicans in the biotope of the intestine as a result of the release of biotopes of competitive microorganisms, due to massive antibiotic therapy. This leads to the development of intestinal candidiasis with or without symptoms, which consistently causes a violation of the immune system function associated with the mucosa and local blood flow. Subsequently, the invasion of C. albians own plate of the intestinal mucosa, colonization of the components of the local immune system. Further developing fungemia (circulating fungi in the blood), systemic candidiasis with secondary lesions of the mucous membranes of the mouth, genital organs, etc. In case of inadequate system response to the constant background of fungemia developed lesions of parenchymal organs, the development of candidal sepsis — blood poisoning.
In the intestine, fungal lesions form ulcers of various sizes and configurations, cracks in the mucous membrane, polypoid and segmental circular formations.
The defeat of the mucous membrane is caused mainly by fungi of the genus Candida, the genus Aspergillus causes tumor-like lesions on the mucous membranes. Clinical symptoms of lesions of the gastrointestinal tract is not expressed, an endoscopic view can be interpreted wrongly.
Immunosuppression, i.e. inhibition of immunity, with chemotherapy of malignant tumors, organ transplantation leads to a comprehensive clinic of systemic candidiasis with lesions of the oral cavity and genitals in half of the patients.
The cause of systemic candidiasis is also extensive burns and surgical interventions, especially on the abdominal organs and against the background of prolonged hypodynamia (immobility), parenteral (intravenous) nutrition, sharp fluctuations in the volume of circulating blood, massive antibiotic therapy. That’s the second most common reason.
Antibiotic therapy is the third most common cause of systemic candidiasis. Appointment Cytotec for 7 days to healthy volunteers resulted in a significant change in the composition of the intestinal microflora: decreased the number of E. coli and the number of enterococci, bacteria of the genera Citrobacter, Klebsiella, and Pseudomonas increased significantly. Of anaerobes decreased number of bifidobacteria, and clostridia lactobacilli. The number of fungi has not decreased and even increased, apparently due to the released biotopes by reducing the number of cells of other bacteria. Among patients with tuberculosis after 3-4 months of tuberculosis therapy, 75 % develop pronounced shifts in the composition of the intestinal microflora, and 58-62 % — intestinal candidiasis. Often, the first symptom of intestinal candidiasis is diarrhea; it is believed that it is associated with intestinal candidiasis about 1/3 of all cases of diarrhea after consuming antibiotics. Cessation of diarrhea coincides with a decrease in the content of fungi of the genus Candida in the intestine.
It is not an indication for the appointment of antifungal therapy the presence of fungi in the stool or in a smear taken from the mouth or vagina. Initially, it is necessary to establish clinical manifestations: itching, inflammation, plaque on the mucous membranes of the oral cavity and genitals, diarrhea, bloating and excessive growth of Candida fungi. Candidiasis of the oral cavity and genitals should be considered a manifestation of generalized candidiasis, since these patients already have systemic candidiasis. Therefore, it is wrong to treat candidiasis of the oral cavity and genitals only by local means. The source of highly virulent strains of fungi that cause damage to the mucous membranes of the oral cavity and genitals is the intestine, and without adequate suppression of fungi in it, therapy is usually unsuccessful. With systemic exposure to antifungal agents, absorbed in the upper intestine, in the right concentrations are allocated to the lumen of the ileum and colon, which concentrated the bulk of fungi in intestinal candidiasis, briefly.