Candidamycosis( thrush) is caused by yeast-like fungi of the genus Candida( most often Candida albicans).In frequency among diseases of the lower part of the genital area, he ranks second after trichomonad colpitis. However, in women's clinics, due attention is not paid to identifying this disease. In this regard, we will dwell on it in more detail.
There is a bright hyperemia of the vulvar mucosa, labia and vagina. Typical are grayish-white curdled raids and superficial ulceration. Sometimes you can see small infiltrates, genital warts, small vesicles and pustules filled with transparent contents. According to most authors, these formations are not foci of mycosis, but allergic manifestations of a fungal disease. However, the most constant and debilitating symptom is a painful itch, which intensifies in the evening and night, during menstruation, with excessive sweating. The appearance of this itch is due to the enzymatic activity of fungi and the breakdown of glycogen cells of the vaginal epithel
ium into a number of acids, which irritate the end of the sensitive nerves of the vaginal mucosa and vulva( FD Aniskova, EV Egorova, 1975). Candidamycosis occurs more often in
women with diabetes, due to glucosuria, as well as in pregnant women due to an increase in their glycogen content in the vaginal epithelial cells. Mycotic colpitis of the pregnant women disappears on their own in the first days after the birth, which, apparently, is associated with hormonal changes in the body of the puerpera and with changes in the acidity of the vaginal contents. To diagnose
candidiasis it is necessary to carefully study the native smears and strokes stained with Gram, Giemsa, Lugol solution or methylene blue. In positive cases, a large number of fungal elements, budding cells, mycelial filaments and blastopores can be detected in smears. In some cases, there is a need to produce culture studies. In this case, the pathology of the pathological material is produced on Saburo's medium or medium prepared from beer wort, to which antibiotics are added to suppress the bacterial flora. An auxiliary role is played also by immunological studies( agglutination and PCK).However, only high titers of the agglutination reaction( over 1:80) and a sharply positive RSA have diagnostic significance. Antifungal antibiotics( nystatin, levorin) are the most effective remedies for candida treatment of
.Nystatin is prescribed for 3-5 million ED, levorin - 1.5 million units per day for 2-3 weeks. Break between treatment courses - 1 week. In addition to oral administration, these drugs are also administered topically in the form of vaginal globules or 5% ointment. Locally, you can apply a 20% solution of borax in glycerin or 1% solution of methylene blue. Treatment in most cases should be done during 2-3 menstrual cycles.
In the absence of the proper effect, a comprehensive clinical examination of the patient is needed to identify foci of candidiasis in other organs of
( in the gastrointestinal tract, lungs, and so on).