Treatment of fungal infections

Says a dermatovenerologist, allergist-immunologist, mycologist,

Candidate of Medical Sciences, Head of the Department of Venereology Nadezhda Batkaeva

Urogynetal candidiasis

Urogenital candidiasis is a fungal disease of the mucous membranes and skin of the genitourinary organs caused by yeast—like fungi of the genus Candida.

Candida albicans can colonize the oral mucosa and mucous membranes of the urogenital tract without causing any clinical manifestations in 70% of healthy people. Representatives of this species are practically not found on healthy skin.

The main route of transmission of urogenital candidiasis is sexual. According to statistics, this method occurs in 30-40% of all cases.

Factors predisposing to infection include:

• Various mechanical lesions of the skin and mucous membranes (for example, injuries, etc.).

• Deficient conditions (vitamin deficiency, anorexia, iron deficiency).

• Hormonal imbalances and dysfunctions of the reproductive system in women, including pregnancy, taking contraceptives in the form of capsules or tablets.

• Senile age.

• Dysfunction of the endocrine system of the body (diabetes mellitus, insufficiency of the adrenal cortex, etc.).

• Congenital defects of the immune system.

• Immune suppression associated with HIV infection, prolonged use of drugs that slow down the function of cell division or steroid hormones.

• Malignant neoplasms, most often of a hematological profile.

• Long-term use of broad-spectrum antibiotics.

The main complaints presented by patients are itching and burning in the vulva and perineum, discharge from the genital tract, urinary disorders, pelvic pain. Symptoms may worsen after sexual intercourse and menstruation.

The main clinical manifestations of urogenital candidiasis in women are inflammation of the vulva and mucous membranes of the vagina, cervix, vagina, urethra, and large sex glands.

In men, the main symptoms are rashes on the skin of the glans penis in the form of a small rash, prone to merging into large foci and wetting erosions. Low-symptomatic forms of candidal balanoposthitis (inflammation of the foreskin and glans penis) are clinically spots of irritation accompanied by burning or itching that occur most often after unprotected sexual intercourse. The pathological process can spread to the skin of the scrotum and inguinal folds.

According to the nature of the course of the disease, there are:

• Candida - carrier (absence of clinical manifestations in laboratory detection of yeast-like fungus in small quantities).

• An acute condition, in this case candidiasis lasts no more than 2 months.

• Chronic, including: a) recurrent - at least 4 episodes per year; b) persistent (permanent) - the symptoms of the disease persist constantly, somewhat decreasing after treatment).

The therapeutic tactics of urogenital candidiasis include local and systemic therapy with antifungal drugs.

The effectiveness of therapy and the reduction in the frequency of relapses depend on the nature of the course of the disease. For example, with chronic recurrent urogenital candidiasis, local therapy alone may not be enough. In this case, a combination treatment is used.

EMC doctors diagnose and treat urogenital candidiasis according to European protocols. The choice of patient management tactics is carried out individually, after determining the type of fungal infection of the genus Candida and its sensitivity to antifungal drugs, which reduces the duration of treatment and ensures maximum effectiveness.