Nolting S, Stanescu-Siegmund A, Schwantes P A
Klinik und Poliklinik für Hautkrankheiten-Allgemeine Dermatologie und Venerologie, Universität Münster/Westfalen.
Fortschr Med. 1998 Feb 28;116(6):22-8.
In immunocompetent persons, Candida species are members of the normal flora of the gastrointestinal tract. Budding yeasts, in particular Candida albicans, can, however, in patients with a corresponding disposition, spread topically and systemically, that is, they may become pathogenic. In hematological/oncological patients with severe immunodeficiency, for example, the mycelium may infiltrate the muscularis mucosae, with involvement also of the vascular system. The relationships between recurrent diarrhea and Candida are still discussed controversial; various data do, however, suggest that massive colonization with Candida might well represent a(n additional) diarrhea-provoking factor. Similar considerations may also be assumed to apply to diarrhea induced by antibiotic therapy. For immunocompetent persons, guidelines exist for the yeast cell count in the stools. The interpretation of quantitative findings must, however, always be made on an individual basis and against the background of clinical symptoms and/or any particular predisposition of the patient. Reliable treatment of superficial candidasis can be achieved with oral polyene antifungal antibiotics (nystatin, amphotericin B).
在免疫功能正常的个体中,念珠菌属是胃肠道正常菌群的一部分。然而,出芽酵母,尤其是白色念珠菌,在具有相应易感性的患者中,可局部和全身扩散,也就是说,它们可能会致病。例如,在严重免疫缺陷的血液学/肿瘤学患者中,菌丝体可能会浸润黏膜肌层,同时累及血管系统。复发性腹泻与念珠菌之间的关系仍存在争议;然而,各种数据表明,念珠菌的大量定植很可能是一个(额外的)引发腹泻的因素。类似的考虑也可能适用于抗生素治疗引起的腹泻。对于免疫功能正常的个体,存在关于粪便中酵母细胞计数的指导原则。然而,定量结果的解读必须始终基于个体情况,并结合临床症状和/或患者的任何特殊易感性。口服多烯类抗真菌抗生素(制霉菌素、两性霉素B)可实现对浅表念珠菌病的可靠治疗。