念珠菌病

1. 念珠菌病 candidiasis

2. 一．Defination candidaalbican may cause different types of lesions of the skin, nails, mucous membranes ,and viscera, which is called candidiasis. normal inhabitant conditioned pathogen, ( autogenous infection ) (1)hypoimmunity (2)local surrounding changed. (3)Antibiotic, immunity inhibiter,etc.

3. 二．Etiopathogenisis Candida albican is the commonest algogen and its virulence is the strongest. normal inhabitant(spore): 1. cell immunity ↓ primary infection: the phagocytosis of neutrophil decreased. Lack of myeloperoxidase and aggregation factors. Second infection: blood glucose↑,VitA ↓,AIDS.

4. Iatrogenic factors:using broad-spectrum antibiotic, adrenal cortex hormone, immunity inhibiter, radiotherapy and chems. Spore hypha Aherence of cell well ↑ The ability of resistence of phagocytosis↑ The production of toxin

5. 三． Clinical apparence : （一） mucocutaneous candidiasis （二） systemic candidiasis （三） disseminated candidiasis

6. 1. thrush • grayish white membrane plaques are found on the surface of the oral mucous membrane, gingival, tongue.

7. 2． Candidal vulvovaginitis ： • white color pseudomembrane • fluor albus↑(cheese, bean dregs secretion) • the cunnus is erythematous and pruritic. • Pregnancy and DM are prone to develop disease . • Pseudohypha and clumped germ.

8. 3. Candida balanitis • （1）Glans and coronary sulcus are susceptible. • （2）Erythema, superficial erosion pseudomembrane • （3）Apparent pruritus • （4）over-long acrobystia and DM are susceptible. • （5） Pseudohypha and clumped germ.

9. 4. Candida fingerweb erosion：related to fatness , occupation etc.

10. 5．Candidal intertrigo 〈1〉Child or obesity. 〈2〉 The folds of the body. 〈3〉 Erubescence, erosion, effusion and incrustation. 〈4〉 Erythraeous papule, desquamation

12. 6． Popular candidiasis • obesity • Chest-back, perineum • Flat dark red papule • With clear boundary and albicans ring scale. • Pruritus.

15. 7． Candidal paronychia and onychitis： Involving finger nail. red swelling nail groove, epinephelus nail plate with white spotting.

16. 8．Chronic mucocutaneous candidiasis • With cryptorrheic or immunocopromiseddisease. • Childhood • Heredity • verrucous hyperplasia with dirty and thick crust.

17. mucocutaneous candidiasis

18. Systemic candidiasis 〈一〉Candia albicans can infect many organs ,including alimentary canal, respiratory apparatus, urinary system, endocardium and meninges. 〈二〉 susceptible population: DM, malignant tumor, leukemia,AIDS 〈三〉 susceptible factors: using the long-time , broad-spectrum antibioticm and corticosteroids; radiotherapy; chemo.

19. disseminated candidiasis 1 involving many systems at the same time 2 candidal septicemia 3 bad prognosis.

20. 四． Diagnosis and differential diagnosis All kinds of clinical appearances and fungi tests(pseudohypha germ and hypha→pathopoiesis)

21. 五 prevention and cure tropical treatment: mucocutaeous type 1． 2％clotrimazole cream , miconazole cream . compound resorcinol liniment+ power 2 ． nystatin100,000u + camphor sulphur calaminalotion 100mlnystatin suspl.( nystatin100,000u+ glycerol20ml+ distilled water80ml) 3． nystatin suppository(5000-10,000 u)qnX1-2w

22. （二） oral medication ： Systemic and disseminated candidiasis or primary candidiasis 1． ketoconazole 0.2qd, vaginitis5-10d. 2． nystatin 200,000-400,000 u qd X 1w(alimentary canal) 3． polyaldehyde nystatin 50,000 u +NS5ml → air duct inhalation 4． amphotericinB5mg + aqua pro injectione20ml →5ml inhalator Bid –qid.

23. 5． AmphotericinB 0.5-1mg/kg/d intravenous drip • or 5-flucytosine 2-3g/d by mouth • 6． Fluconazol:50-100mg/d, • course of treatment according to pathogenetic condition • Itraconazole 0.2g/d • course of treatment according to pathogenetic condition • 8. Take-down cause of a disease and preservation