Oral cavity candidiasis – the mikotichesky infection of an oral cavity caused by opportunistic drozhzhepodobny mushrooms of Candida albicans. Candidiasis of an oral cavity is shown by hyperaemia and swelling mucous with soft or dense plaques of a white raid; dryness, burning, pain at meal; zayeda, peeling and cracks of lips. The diagnosis of candidiasis of an oral cavity is based on a typical clinical picture and identification of the activator at a microscopic and bacteriological research. Treatment of candidiasis of an oral cavity includes purpose of antifungal medicines (locally and inside), reception of antihistamines and vitamins, an immunotherapy, physiotherapy.
Oral cavity candidiasis
Oral cavity candidiasis – disbiotichesky damage of a mucous oral cavity which develops at plentiful reproduction of drozhzhepodobny mushrooms of the sort Candida, being an assotsiant of normal microflora of the person. Under certain conditions fungi are capable to cause various pathological processes in a human body: oral cavity candidiasis, skin candidiasis, vaginal candidiasis, kandidozny sepsis, etc. Candidiasis of a mucous membrane of an oral cavity is often observed at children (in the period of a neonatality, chest and younger age), and also at elderly people. For example, kandidozny zayeda meet at children of 3-10 years more often and at patients 60 years are more senior. Kandidozny stomatitis also glossit usually comes to light at newborns and women after approach have menopauses.
Oral cavity candidiasis reasons
Transfer of the causative agent of candidiasis of an oral cavity is possible at physical contact with the carrier (through hands, saliva at kisses), through obsemenenny ware, toys, food (especially dairy products) and water. Infection with mushrooms Candida of the newborn from mother at the time of delivery is possible, and also when feeding by a breast.
However only one hit of mushrooms Candida on mucous is not enough mouth for colonization and development of candidiasis. Not attached mushrooms can be easily removed from an oral cavity with saliva and food in a GIT and are brought out of an organism. In realization of pathogenic properties of mushrooms Candida a role of the contributing factors is played by easing or violation of immunobiological resistance of an organism, including specific and nonspecific factors of local immunity, oppression of normal microflora, oral cavity dysbacteriosis.
Development of candidiasis of an oral cavity is promoted by pregnancy, prematurity and a hypotrophy; existence of the congenital or acquired immunodeficiency (HIV infection), serious associated diseases (malignant tumors, tuberculosis), sharp infectious processes (dysentery, diphtheria, syphilis), endokrinopatiya (diabetes, a hypothyroidism), exchange diseases (iron deficiency states, hypovitaminosis).
Chronic gastrointestinal diseases, giposalivation and kserostomiya, low saliva, the lowered acidity of gastric juice also cause tendency to development of candidiasis of an oral cavity. In developing of candidiasis of an oral cavity the age of the patient (children's and elderly), long-term treatment by antibiotics, hormonal medicines (the COOK, corticosteroids), cytostatics, addictions (smoking) matters.
Decrease in resistance mucous and emergence of candidiasis of an oral cavity can be caused by various injuries of a mucous membrane caused by poor adjusted dentures, keen edges of the destroyed crowns of teeth, thermal or chemical burns.
Oral cavity candidiasis symptoms
Clinical displays of candidiasis of an oral cavity are rather various and can be expressed as barmy stomatitis (milkwoman), a glossit, a heylit, an angulit. Allocate sharp (psevdomembranozny and atrophic) and chronic (hyper plastic and atrophic) clinical forms of candidiasis of an oral cavity.
The most widespread sharp psevdomembranozny candidiasis of an oral cavity occurs mainly at children of the first years of life, and also the weakened and exhausted elderly people. It is characterized by emergence of puffiness, hyperaemia and a milky-white curdled raid on a mucous membrane of a back of language, the sky, cheeks and lips. Removal of a raid bares the matserirovanny or erozirovanny bleeding surface of mucous. Burning, morbidity and difficulty at meal is noted; children lose appetite, becomes sluggish, whimsical. Process can extend to a throat, a throat, a gullet.
In lack of treatment the milkwoman can pass into the sharp atrophic candidiasis of an oral cavity which is followed by a slushchivaniye of an epithelium, the expressed hyperaemia, hypostasis and dryness the thinned mucous, severe pain. The back of language gets bright-red coloring and gloss, threadlike nipples atrophy, the red border of lips and corners of a mouth is surprised. The fungal raid is absent or accumulates in deep folds, difficult gives in to removal.
In case of chronic hyper plastic candidiasis of an oral cavity on mucous cheeks and a back of language densely soldered gray-white plaques and papules with hyperaemia rim which when scraping are not removed are found irregular shape. Patients with this form of candidiasis are disturbed by considerable dryness in oral cavities, a roughness and morbidity mucous language and cheeks. The disease comes to light usually at males 30 years are more senior.
Chronic atrophic candidiasis of an oral cavity (stomatitis of dentures) is connected with the long pressure and a travmatization mucous. It is shown by local defeat of a zone of carrying an artificial limb in the form of accurately outlined bright eritema of a mucous membrane of gums and the sky, small for a short while, erosion of corners of a mouth. Language is smooth, with an atrophy of nipples. Subjective feelings - pain, burning, dryness.
Upon transition of candidiasis to a red border of lips kandidozny develops heylit, characterized by moderate hypostasis, maceration and a superficial peeling of lips, the painful bleeding cracks and erosion, increase of thin grayish films and crusts. Burning, dryness, feeling of tightening of a mucous membrane of lips is noted.
At a mikotichesky zayeda in mouth corners on both sides there is a maceration mucous, dry cracks with reinforced valikoobrazny edges and thin gray scales. At a dehiscence of a mouth of a crack bleed, cause pain. Candidiasis of an oral cavity can proceed separately or be combined with damage of other mucous membranes and skin; under adverse conditions and the wrong treatment can pass into a generalized kandidamikoz with damage of internals, development of kandidozny sepsis.
Diagnosis of candidiasis of an oral cavity
The diagnosis of candidiasis is based on existence of characteristic complaints and clinical manifestations, results of laboratory researches (a microscopic research of scrape, the quantitative analysis of degree of an obsemeneniye of an oral cavity, crops on candidiasis with definition of sensitivity to medicines). Survey of a mucous membrane of an oral cavity at the stomatologist allows to reveal defeats, typical for candidiasis. If necessary consultations of the therapist, pediatrician, infectiologist, allergist-immunologist, endocrinologist are held.
Candidiasis of an oral cavity is confirmed by detection of mushrooms of Candida in the form of the budding cellular forms and threads of a pseudo-mycelium at survey microscopy of the painted dabs from affected areas of mucous. Allocation at crops on nutrient mediums from 100 to 1000 WHICH mushrooms Candida from a mucous oral cavity is treated as a possible symptom of candidiasis. If necessary serological researches - an intracutaneous allergoproba on Candida anti-gene, definition of antibodies to Candida IgG/IgA and PTsR-diagnostics of scrape are conducted. At recurrent candidiasis of an oral cavity blood glucose level for a diabetes exception is investigated.
Candidiasis of an oral cavity should be differentiated from a flat and verrukozny form of a leukoplakia, red flat depriving, allergic and chronic aftozny stomatitis, a deskvamativny glossit, a streptococcal zayeda, an aktinichesky heylit, simple herpes, a syphilitic papule, eczema of lips, etc.
Treatment of candidiasis of an oral cavity
Complex treatment of candidiasis includes local and general methods: processing and sanitation of an oral cavity, treatment of associated diseases, increase in factors of immune protection. Alkalizing rinsings and applications (solutions of baking soda, boric acid, sodium tetraborathat in glycerin, a klotrimazola), greasings by antifungal ointments are applied to local treatment of candidiasis of an oral cavity (nistatinovy, levorinovy and dekaminovy). For the best effect alternate 2-3 different medicines-antimycotics during the day to replacement in 2-3 days by new.
Processing of an oral cavity is recommended by solutions of a fukortsin, lugol, a yodinol. From 4-5 in the afternoon from the beginning of therapy application of keratoplastichesky means is possible (vitamins A and E, oils of a dogrose, sea-buckthorn oil). Careful processing of dentures and orthodontic designs is shown. For the general influence on the causative agent of candidiasis of an oral cavity antifungal means inside are appointed (, , In, ). For reduction of allergic manifestations use antihistaminic medicines. At candidiasis of an oral cavity physiotherapy - an electrophoresis with solution of potassium of iodide, Ural federal district, laser therapy is effective. In hard cases of candidiasis of an oral cavity the complex immunotherapy is necessary.
The course of treatment of candidiasis of an oral cavity proceeds not less than 7-10 days after disappearance of all clinical manifestations; at a chronic form courses repeat for the prevention of a recurrence. Therapy of candidiasis of an oral cavity includes whenever possible cancellation or decrease in a dose of the accepted antibiotics, corticosteroids; treatment of associated diseases. Good nutrition with reduction of amount of simple carbohydrates, reception of vitamins of group B, PP, C is important for patients with candidiasis of an oral cavity. At a recidivous kandidozny zayeda prosthetics is necessary for return of height of a bite.
Forecast and prevention of candidiasis of an oral cavity
The forecast at an easy form of candidiasis of an oral cavity favorable, a recurrence does not arise; at a medium-weight form – the probability of a recurrence exists; at heavy – transition to a chronic infection with development of kandidozny sepsis is possible.
Prevention of candidiasis of an oral cavity includes strengthening of health and a hardening of an organism, the correct diet, sanitation of an oral cavity, observance of rules of personal and general hygiene, timely detection and treatment of dysbacteriosis, inadmissibility of self-treatment by medicines, observance of the sanitary and hygienic mode at the enterprises of the food industry and in medical institutions. It is important to carry out elimination of the centers of a kandidozny infection at pregnant women and the correct hygienic care of babies.