The candidiasis diagnosis is put on the basis of the clinical data, by detection at microscopy characteristic psevdomitselija and a considerable quantity of budding cells (blastospor) in native preparations or smears (colouring on Romanovsky Gimze, Gramu, Tsilju - to Nilsen), prepared of belesovatyh scurfs from a mucosa and a skin. Kulturalnoe research is used for specification of a specific accessory of mushrooms. Identification of strains S albicans is spent also by means of PTSR. Isolation testifies To presence kandidanositelstva more than 10 WHICH of 1 ml of the first portion of urine.
For candidiasis diagnostics also use serological tests: an agglutination test (RAG), a reaction of binding complement (RSK), a precipitation test (RP), reaction of a passive hemagglutination (RPGA). In vulval washouts at women by means of an enzyme immunoassay (IFA) define IgпїЅ against S albicans.
Treatment: elimination of the factors promoting development of a candidiasis; a diet with an exception of sweets, restriction of the carbohydrates, rich with fibers; vitamins пїЅ2, пїЅ6, With and RR. At easy variants of a candidiasis of a skin and mucosas are limited to external medical products: a cream, suspension pimafutsina, creams and ointments - Mycosolonum, Miconazolum, ekonazol, lamizil; Clotrimazolum solution; solutions tetraborata sodium (bur) in Glycerinum, 1-2 % water and spirituous solutions of aniline stains (diamond green, Birth Control Tips, a methylrosanilinum chloride), mikoseptin, Unguentum Nystatini, etc. Preparations it is necessary to inflict 5-20 % on the centres of a lesion 2 times a day (creams and ointments slightly to rub) before full retrogress of clinical implications, then, having reduced applications to 1 in 2-3 days to continue treatment 2-3 more ned. At treatment of acute forms of an urogenital candidiasis also are usually limited to local medical products.
Treatment of a chronic relapsing urogenital candidiasis should be complex: along with local treatment, immuno, a vitamin therapy (group) prescribe one of system antimikotikov: ketokonazol (nizoral, oronazol 0,2) on 1 tablet 2 times a day 5 days; itrakonazol (orungal) on 200 mg a day 3 days; flukonazol (difljukan - capsules on 0,05 g; 0,15 g; 0,1 g; 0,2 g, the solution to intravenous introduction is applied unitary in a dose by of 150 mg); natamitsin (pimafutsin 0,1) on 1 tablet 4 times a day within 7-12 days; sometimes (1 % a cream batrafen) combine local treatment with intake of one capsule (150 mg) flukonazola. At a widespread candidiasis, serious and its persistent current, and also at failures of external therapy system treatment is shown. Use three groups of antimicotic preparations: triazoly, imidazoles and polienovye antibiotics. From triazolov apply flukonazol (difljukan) in a dose of 50-100 mg/sut (in the form of gelatinous capsules, a syrup or a solution to the intravenous introduction containing 2 mg/ml flukonazola) or trakonazol on 100 mg/sut within 7-14 days. At a widespread (system) candidiasis the daily dose makes 400 mg flukonazola in 1 j day and 200 mg the next days. Widely apply nizoral - on 200 mg / sut, at persistent forms a daily dose enlarge to 400 mg. Treatment continue before recover. Polienovye antibiotics prescribe nystatin and Levorinum accordingly on 10 000 000 12 000 000 and 5 000 000 6 000 000 ED a day in 3 4 receptions during Birth Control Tips, repeated courses spend with intervals in 8-10 days. Good results gives terbinafin (lamizil) as at the general (250 mg unitary a day), and at local (1 % a cream) application. It is most active orungal.
Candidiasis preventive maintenance consists in the prevention of its development in the persons entering into group of risk, - patients with immunodefitsitnymi conditions, illnesses of a blood, neoplasms and other serious pathology, and also received an ionising radiation, passed massive treatment by antibiotics, corticosteroid hormones and other immunodepressants. At detection at them mikonositelstva prescribe during 3-4 ned on 2 000 000 ED nystatin or 100 mg nizorala a day. The special attention is given to correction of a dysbacteriosis of an intestine, treatment of sexual partners at a genital candidiasis, to revealing and treatment of a candidiasis at pregnant women and children of thoracal age, to an exception of corresponding harmfulnesses on manufacture.
DEEP MYCOSES The group of deep mycoses includes diseases which basically are extended in the countries of the South America, to Africa, the USA, in territory of Europe including in Russia there are only sporadic not numerous cases of diseases of this group, except for an actinomycosis which is carried now to pseudo-mycoses. Into group of deep mycoses enter a zymonematosis North American, a zymonematosis keloidnyj, a sporotrichosis, hromomikoz and variety of others. It is possible to consider as characteristic feature of deep mycoses their weak contageousness, diffusion of originators of these diseases in soil, on plants as saprophytes, mainly in a tropical climate.
Infection arises at a becoming infected of traumas of a skin, scratches, cracks. In a clinical picture of deep mycoses morphological elements of type bugorkov, the knots inclined to disintegration with formation of ulcers and a lesion of deep layers of a skin, the hypodermic fat, subject muscles, bones, an internal that defines a variety of a clinical picture and sometimes the serious general semiology which is not excluding a lethal outcome prevail. Zymonematosis North American (sin. The zymonematosis of Gilkrista) - the deep mycosis caused Blastomyces dermatitidis, is characterised torpidly flowing jazvenno granulematoznymi lesions of a skin, mucosas, is more rare than bones and an internal. The clinical picture is characterised in the beginning uzelkovo by pustular elements which quickly merge and izjazvljajutsja with formation of vegetans ulcers of brightly red colour quite often with a warty component, ulcers to a bowl are localised on extremities. Since a bottom of an ulcer it is allocated viscous krovjanisto a purulent exsudate which shrinks in crusts. On a place of ulcers there are deep cicatrixes. The diagnosis proves to be true bakterioskopicheski and kulturalno. Treatment: Amphotericinum In, iodine preparations, orungal, flukonazol.
The zymonematosis keloidnyj (illness of Lobo) - the deep mycosis caused Clenosporella loboi, is characterised by rather good-quality current with a deep lesion of a skin more often in area of feet, anticnemions, is more rare than the person. In the beginning on a place of introduction of an infection arise small cyanotically red colour bugorkovye the elements turning gradually in confluent knots with predilection to a necrosis and an ulceration. Ulcers become covered by purulent scurf and warty growths. On a place them painful rasping keloid cicatrixes are formed. The diagnosis proves to be true bakteriologicheski and kulturalno. Treatment - Amphotericinum V nizoral, orungal, flukonazol, surgical excising of the centres.
The sporotrichosis - the deep mycosis caused Birth Control Tips schenckii and amazing a skin, a hypodermic fat, mucosas, lymphatic system, is more rare bones and an internal. Meets as occupational disease at working vegetative nurseries. Entrance collars are microtraumas of a skin and mucosas, the becoming infected through respiratory tracts and a digestive tube is possible. Distinguish a sporotrichosis localised hypodermic, disseminirovannyj gummozno ulcerative, visceral (system). On a place of introduction of a mushroom there are dense is red brown bugorki which are enlarged in size, being accustomed to drinking with surrounding tissues, and, izjazvljajas, form "sporotrihoznye shankry" - ulcers with rough papillomatous growths by a bottom and podrytymi edges. Then on a course of lymphatic vessels arise bugorki and the gummatous knots also inclined to disintegration. For disseminirovannogo a sporotrichosis the hematogenic innidiation of the originator with formation of cold abscesses with fistulous courses is characteristic and is long not healing ulcers. From visceral organs kidneys, testicles is more often are surprised, lungs, a digestive tube, a liver, bones and joints are more rare. The general condition is broken, the cachexia, a hematosepsis accrues. The diagnosis proves to be true bakterioskopicheski and kulturalno. Treatment: iodine preparations, Amphotericinum In, orungal, nizoral, flukonazol, Birth Control pills.
Hromomikoz - the deep mycosis caused by mushrooms of sort Hormodendron with rather good-quality current. It is characterised by a lesion of mainly bottom extremities where on a place of introduction of the originator appears nasyshchenno red colour bugorok which slowly grows, being accompanied by occurrence of new elements (bugorkovaja the form), not merging with each other. In case of their merge on a skin the deep infiltrate in the form of a conglomerate bugorkov which sharply tower over a skin, izjazvljajutsja with formation of the extensive papillomatous growths alternating with sites of a necrosis, separating krovjanisto a purulent liquid (sosochkovo the ulcerative form) is formed. Formation of knots (the gummatous form) is less often observed. The diagnosis proves to be true bakterioskopicheski and kulturalno. Treatment: cryotherapy, surgical excising, an electrocoagulation, inside iodine preparations, Amphotericinum In in a kind obkalyvanija the centres, orungal. Preventive maintenance of deep mycoses consists in the prevention and timely sanation of microtraumas.
DEEP MYCOSES The group of deep mycoses includes diseases which basically are extended in the countries of the South America, to Africa, the USA, in territory of Europe including in Russia there are only sporadic not numerous cases of diseases of this group, except for an actinomycosis which is carried now to pseudo-mycoses. Into group of deep mycoses enter a zymonematosis North American, a zymonematosis keloidnyj, a sporotrichosis, hromomikoz and variety of others. It is possible to consider as characteristic feature of deep mycoses their weak contageousness, diffusion of originators of these diseases in soil, on plants as saprophytes, mainly in a tropical climate.
Infection arises at a becoming infected of traumas of a skin, scratches, cracks. In a clinical picture of deep mycoses morphological elements of type bugorkov, the knots inclined to disintegration with formation of ulcers and a lesion of deep layers of a skin, the hypodermic fat, subject muscles, bones, an internal that defines a variety of a clinical picture and sometimes the serious general semiology which is not excluding a lethal outcome prevail. Zymonematosis North American (sin. The zymonematosis of Gilkrista) - the deep mycosis caused Blastomyces dermatitidis, is characterised torpidly flowing jazvenno granulematoznymi lesions of a skin, mucosas, is more rare than bones and an internal. The clinical picture is characterised in the beginning uzelkovo by pustular elements which quickly merge and izjazvljajutsja with formation of vegetans ulcers of brightly red colour quite often with a warty component, ulcers to a bowl are localised on extremities. Since a bottom of an ulcer it is allocated viscous krovjanisto a purulent exsudate which shrinks in crusts. On a place of ulcers there are deep cicatrixes. The diagnosis proves to be true bakterioskopicheski and kulturalno. Treatment: Amphotericinum In, iodine preparations, orungal, flukonazol.
The zymonematosis keloidnyj (illness of Lobo) - the deep mycosis caused Clenosporella loboi, is characterised by rather good-quality current with a deep lesion of a skin more often in area of feet, anticnemions, is more rare than the person. In the beginning on a place of introduction of an infection arise small cyanotically red colour bugorkovye the elements turning gradually in confluent knots with predilection to a necrosis and an ulceration. Ulcers become covered by purulent scurf and warty growths. On a place them painful rasping keloid cicatrixes are formed. The diagnosis proves to be true bakteriologicheski and kulturalno. Treatment - Amphotericinum V nizoral, orungal, flukonazol, surgical excising of the centres.
The sporotrichosis - the deep mycosis caused Birth Control Tips schenckii and amazing a skin, a hypodermic fat, mucosas, lymphatic system, is more rare bones and an internal. Meets as occupational disease at working vegetative nurseries. Entrance collars are microtraumas of a skin and mucosas, the becoming infected through respiratory tracts and a digestive tube is possible. Distinguish a sporotrichosis localised hypodermic, disseminirovannyj gummozno ulcerative, visceral (system). On a place of introduction of a mushroom there are dense is red brown bugorki which are enlarged in size, being accustomed to drinking with surrounding tissues, and, izjazvljajas, form "sporotrihoznye shankry" - ulcers with rough papillomatous growths by a bottom and podrytymi edges. Then on a course of lymphatic vessels arise bugorki and the gummatous knots also inclined to disintegration. For disseminirovannogo a sporotrichosis the hematogenic innidiation of the originator with formation of cold abscesses with fistulous courses is characteristic and is long not healing ulcers. From visceral organs kidneys, testicles is more often are surprised, lungs, a digestive tube, a liver, bones and joints are more rare. The general condition is broken, the cachexia, a hematosepsis accrues. The diagnosis proves to be true bakterioskopicheski and kulturalno. Treatment: iodine preparations, Amphotericinum In, orungal, nizoral, flukonazol, Birth Control pills.
Hromomikoz - the deep mycosis caused by mushrooms of sort Hormodendron with rather good-quality current. It is characterised by a lesion of mainly bottom extremities where on a place of introduction of the originator appears nasyshchenno red colour bugorok which slowly grows, being accompanied by occurrence of new elements (bugorkovaja the form), not merging with each other. In case of their merge on a skin the deep infiltrate in the form of a conglomerate bugorkov which sharply tower over a skin, izjazvljajutsja with formation of the extensive papillomatous growths alternating with sites of a necrosis, separating krovjanisto a purulent liquid (sosochkovo the ulcerative form) is formed. Formation of knots (the gummatous form) is less often observed. The diagnosis proves to be true bakterioskopicheski and kulturalno. Treatment: cryotherapy, surgical excising, an electrocoagulation, inside iodine preparations, Amphotericinum In in a kind obkalyvanija the centres, orungal. Preventive maintenance of deep mycoses consists in the prevention and timely sanation of microtraumas.