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念珠菌病

Candidiasis

作者信息

R Arya N., Rafiq Naureen B.

机构信息

Sri Sankara Dental College, Kerala University of Health Sciences

Creighton university school of Medicine

Abstract

Candidiasis is an opportunistic infection caused by Candida, a type of fungi. Fungi are eukaryotic organisms found in the form of yeasts, molds, or dimorphic fungi. is a form of yeast. Candidiasis occurs most commonly as a secondary infection in immunocompromised individuals. Synonyms of candidiasis include candidosis, moniliasis, and thrush. These are common inhabitants in the oral cavity, gastrointestinal tract, vagina penis, or other parts. They become pathogenic only when favorable conditions arise.  It can affect the oral cavity, vagina, penis, or other parts of the body. Candidiasis affecting the mouth is commonly called thrush. It presents as white patches on the tongue, throat, and other mouth areas. Soreness and difficulty in swallowing include other symptoms associated with thrush. The vagina, when affected with , is called a yeast infection.  Oral candidiasis can be pseudomembranous, erythematous, and chronic hyperplastic candidiasis. Pseudomembranous candidiasis is common in chronically ill patients and infants. It is presented as white, soft, slightly elevated plaques most commonly on the tongue and buccal mucosa. Plaques resemble curd and consist of tangled masses of fungal hyphae with intermingled desquamated epithelium, necrotic debris, keratin, leukocyte, fibrin, and bacteria. This white plaque, when wiped away, leaves an erythematous area. Erythematous candidiasis is also known as antibiotic sore mouth. It occurs as a sequel to the use of broad-spectrum antibiotics or corticosteroids. The lesions present as consistently painful erythematous areas along with central papillary atrophy of the tongue. It is also known as a kissing lesion when the palate is involved and exhibits erythema due to contact with the tongue.  Chronic hyperplastic candidiasis, also known as candidal leukoplakia, presents with firm white persistent plaques on lips, tongue, and buccal mucosa. These plaques may be homogenous or nodular and persist for years. It has premalignant potential. Candida associated lesions include denture stomatitis, angular cheilitis, and median rhomboid glossitis. Secondary oral candidiasis can also occur, which include chronic mucocutaneous candidiasis, chronic familial candidiasis, chronic localized mucocutaneous candidiasis, chronic diffuse mucocutaneous candidiasis, and candidiasis endocrinopathy syndrome. Vaginal candidiasis presents with genital itching, burning, and a white "cottage cheese-like" discharge from the vagina. The penis is less commonly affected by a yeast infection and may present with an itchy rash. Yeast infections may spread to other parts of the body resulting in fevers along with other symptoms and become invasive rarely.  Oral candidiasis is one of the most common fungal infections, affecting the oral mucosa. The yeast cause these lesions.  are among the components of normal oral microflora, and around 30% to 50% of people carry this organism. The rate of carriage increases with the age of the patient.  are recovered from 60% of dentate patients' mouths over the age of 60 years. There are many forms of species, which present in the oral cavity. Species of oral Candida include , , , , , , and . Oral candidiasis may present as a variety of disease entities in both normal hosts and the immunocompromised. These include hyperplastic or atrophic (denture) candidiasis, pseudomembranous candidiasis (thrush), linear gingival erythema, median rhomboid glossitis, and angular cheilitis. It can result in a broad range of clinical manifestations ranging from mild acute superficial infections to fatal disseminated disease. Disseminated candidiasis is almost exclusively in acquired or inherited immuno-deficiencies. Superficial candidiasis is the most common form.

摘要

念珠菌病是由念珠菌属真菌引起的一种机会性感染。真菌是真核生物,有酵母、霉菌或双相真菌等形式。白色念珠菌是酵母的一种形式。念珠菌病最常见于免疫功能低下个体的继发感染。念珠菌病的同义词包括念珠菌症、念珠菌病和鹅口疮。它们是口腔、胃肠道、阴道、阴茎或身体其他部位的常见寄居菌。只有在有利条件出现时,它们才会致病。它可影响口腔、阴道、阴茎或身体的其他部位。影响口腔的念珠菌病通常称为鹅口疮。其表现为舌头、喉咙和口腔其他部位出现白色斑块。吞咽疼痛和困难是与鹅口疮相关的其他症状。阴道受感染时称为酵母菌感染。口腔念珠菌病可分为假膜型、红斑型和慢性增生型念珠菌病。假膜型念珠菌病常见于慢性病患者和婴儿。表现为白色、柔软、稍有隆起的斑块,最常见于舌头和颊黏膜。斑块类似凝乳,由纠结成团的真菌菌丝与脱落的上皮、坏死碎片、角蛋白、白细胞、纤维蛋白和细菌混合而成。这种白色斑块擦去后会留下红斑区域。红斑型念珠菌病也称为抗生素性口疮。它是使用广谱抗生素或皮质类固醇后的后遗症。病变表现为持续疼痛的红斑区域以及舌头中央乳头萎缩。当腭部受累并因与舌头接触而出现红斑时,也称为接吻性病变。慢性增生型念珠菌病,也称为念珠菌性白斑,表现为嘴唇、舌头和颊黏膜上坚硬的白色持续性斑块。这些斑块可能是均质的或结节状的,会持续数年。它有恶变潜能。念珠菌相关病变包括义齿性口炎、口角炎和正中菱形舌炎。也可发生继发性口腔念珠菌病,包括慢性黏膜皮肤念珠菌病、慢性家族性念珠菌病、慢性局限性黏膜皮肤念珠菌病、慢性播散性黏膜皮肤念珠菌病和念珠菌病内分泌病综合征。阴道念珠菌病表现为生殖器瘙痒、灼痛以及从阴道排出白色“凝乳状”分泌物。阴茎较少受到酵母菌感染,可能出现瘙痒性皮疹。酵母菌感染可能扩散到身体其他部位,导致发热及其他症状,很少会发展为侵袭性感染。口腔念珠菌病是最常见的真菌感染之一,会影响口腔黏膜。白色念珠菌导致这些病变。白色念珠菌是正常口腔微生物群的组成部分之一,约30%至50%的人携带这种微生物。携带率随患者年龄增加而升高。60岁以上有牙患者的口腔中,60%可检出白色念珠菌。口腔念珠菌有多种形式。口腔念珠菌的种类包括白色念珠菌、热带念珠菌、近平滑念珠菌、光滑念珠菌、克柔念珠菌、乳酒念珠菌和季也蒙念珠菌。口腔念珠菌病在正常宿主和免疫功能低下者中可能表现为多种疾病形式。这些包括增生性或萎缩性(义齿性)念珠菌病、假膜型念珠菌病(鹅口疮)、线性牙龈红斑、正中菱形舌炎和口角炎。它可导致从轻度急性浅表感染到致命播散性疾病等广泛的临床表现。播散性念珠菌病几乎仅见于获得性或遗传性免疫缺陷患者。浅表性念珠菌病是最常见的形式。

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