The candidoses are infections due to Levure S, whose only certain species can be pathogenic for the man. They are Saprophyte S human or animal.

The " term; candidoses" indicate the whole of the human pathological demonstrations having for factors of the mushrooms levuriformes kind candida.

Candida albicans , the most frequent species, fact part of the usual flora of the Mouth or the digestive Tract, but can also be present in small quantity in the flora Vagin normal ale.

Cutanéomuqueuses candidoses

Heat and moisture are responsible for candidoses local, often on the level of the cutaneous folds, involving redness, pains, and Prurit.

• large folds (groins, gluteus, armpits)
• small folds (toes)
• Perlèche S

The oral candidose is the mucous demonstration most current, and its frequency increases the immunizing deficit parallel to, being able to take the form of candidose oropharyngée or œsophagienne within the framework of the infection with HIV.

• mucous oral (lily of the valley of the infant)
• black villous language

Other mucous membranes can be reached:

• mucous anal: anite;

• or genital:

At the woman, one is in the presence of a vulvovaginite with prurit, Leucorrhée S blanchâtres, Dyspareunie, edema vulvovaginal. If the repetitions follow one another, it is necessary to seek a local factor supporting ( Voir the article Vaginite candidosic ):

• a digestive colonization
• a Diabetes sweetened
• an infection with HIV
• a recontamination by the partner untreated.

At the man, the infection is generally asymptomatic, but can be appeared as a urethritis sometimes associated with a Balanite.

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Mycoses

Systemic candidoses

The systemic candidoses are rare but serious, with a percentage of death bordering the 50%.

They are the most serious demonstrations of the Candida.

The supporting factors are: the Catheter S intravenous for parenteral nutrition, the Mucous ulceration of the S, the digestive surgical operations, the massive antibiothérapie, patients of Reanimation and badly burned persons.

Septicaemia with Candida

• Definition

The Septicaemia with Candida , formerly regarded as very rare demonstration of the pathogenic action of yeast, currently occupies a place of foreground because of its lately acquired character of iatrogenic Maladie. It appears indeed with an increasing frequency among patients hospitalized in the services of Respiratory assistance, Hématologie and Chirurgie where, by its death rate, it deprives half of those which it reaches of the benefit of their cure.

• Biology

The responsible candida are not only Candida albicans (70% of septicaemias with Fungi), but also several other species which were regarded until now as inoffensive: Candida parapsilosis is currently regarded as a significant cause of septicaemias and fabric infections among patients immuno-compromise while the Candida tropicalis, Candida krusei and Candida guillermondii seldom involve real problems at the man. Let us note that currently noncandidosic yeasts can be responsible for such septicaemias: Torupsis glabrata in particular is regarded as being a highly pathogenic opportunist mycosis of the urogenital system and blood torrent (10% of fungic septicaemias).

Septicaemia can be of endogenous or exogenic origin: --- Endogenous --- when commensaux candida or already slightly pathogenic (oral Lily of the valley, Onyxis…) an exacerbated virulence, their carrier have being subjected to a massive Antibiothérapie, Immunosuppresseur S with the long course (treatment Oncologique e.g.) or suffering of severe a Neutropénie. --- Exogenic --- when the yeasts in question are introduced into the organization weakened by the Canule S or Cathéter S of perfusion maintained with residence.

• Clinical

In the 2 cases, the result is a traditional septicaemia not Pathognomonique leading sometimes to endocarditic localizations of fatal forecast at present whatever the therapeutic one used.

• Diagnosis

It rests on repeated insulation, several days of continuation, yeast accused at the beginning of Hémoculture S on modern bottles for bacteriological hémocultures, under reduced pressure (heart-brain, aerobes). The indirect Immunofluorescence, practiced with yeast isolated and for C. albicans, on stocks of reference, will make it possible to separate a simple levuremy from true septicaemias, and to typify the candida (Sérotype has or B).

• Treatment

At present, one has recourse to antifongic Fongicide S like the Amphotéricine B or the more recent Fluconazole.

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