Candida colpitis - this change in the vaginal mucosa due to infection by yeast fungi to the weakening of local and systemic mechanisms of immune protection.As particular candidal vaginitis may be noted not only by its high prevalence (47%), unusual mechanism of infection and fungal infection.The disease is triggered by not hitting the outside pathological microorganisms , and their own living in the vaginal mucous of any healthy woman, fungi Candida.
causes and mechanisms of vulvovaginal inflammation explain modern concepts of normal vaginal microflora.Vaginal microenvironment differs considerable diversity of species (40 species).Those who live in it microorganisms form associations and hold their ecological niches in the mucous.Therefore, every woman has a "his" inherent only to her, microbiocenosis vaginal mucosa.
Regardless of the unique composition of the microflora vaginal environment has required constant characteristics: the ratio of microbial populations and the l
Normally, the vagina has a significant (95-98%), the number of lactic acid bacteria and the smallest association of opportunistic pathogens, which often represented by streptococci, staphylococci, anaerobic flora, mycoplasmas, gardnerellami, E. coli and many other microbes.Also in healthy vaginal mucous consisting opportunistic associations may be present and fungi.
Lactobacilli synthesize lactic acid and thus maintain a constant level of pH in the range 3.8 - 4.5, which prevents unwanted microflora multiply and provoke inflammation.
As long as lactobacilli retain a significant numerical advantage, the vaginal mucosa is protected from infection.If, because of adverse factors, their number is reduced, opportunistic bacteria begin to vegetate and strenuously tried to oust the remaining lactoflora.By this mechanism, formed the majority of non-specific inflammatory infection in the vaginal mucosa, including Candida infections.
Since the vaginal microenvironment operates on the principle of self-regulation, it is able to cope with fluctuations in the microbial composition of its own, but only if well-functioning immune defense.Individual episodes of vaginal dysbiosis with symptoms of vulvovaginal inflammation occur in 75% of healthy women, but the disease develops only with the "bad" immunity.
Candida colpitis clinic often has a bright and persistent, relapsing course.Its symptoms are similar to those at other obesity etiology, so reliable diagnosis is established only after laboratory studies.If the material (smear, culture) Candida fungi found in high concentrations, the treatment of vaginitis involves antifungal therapy.
Candida colpitis during pregnancy is diagnosed in 2 - 3 times more likely than non-pregnant.Its appearance is due to the natural quantitative changes in the composition of the local flora and decreased immune defense.
Causes Candida vaginitis
culprits infectious inflammation of the vagina are belonging to the genus Candida yeast-like fungi.Their presence on the mucous membranes of the vagina of healthy women considered to be the physiological norm.Symptoms of Candida vaginitis arise only when damage to the protective immune mechanisms when fungal colonies become so numerous that provoke inflammation.
Precipitating factors candidiasis colpitis divided into:
- Pregnancy.40-60% of pregnant women suffer from candidiasis colpitis for quite natural reasons.Status vaginal epithelium is dependent on estrogen levels, which help to keep the lactobacilli quantitative advantage.Natural hormonal changes in the body of a pregnant, together with changes in the immune defense can trigger candidiasis inflammation.Similar reasons provoke the development of fungal infection in breastfeeding in the first months after birth.
- postmenopausal women.Natural extinction of hormonal function in elderly patients leads to structural changes of the mucous: in the absence of adequate estrogen effect of the vaginal mucosa thinning (atrophy), and lactoflora gradually loses the dominant role.
- menstruation.Candida coleitis usually manifests in the second phase of the cycle, when estrogen levels decrease.
- Children and adolescence.Children's vagina thin mucous and immune defense mechanisms do not work properly.
adolescent girls candidiasis colpitis has dishormonal nature.
2. Mechanical.They are based on vaginal epithelium is damaged during the abortion, diagnostic or therapeutic manipulation, intrauterine contraception.When appears on the mucous of land damage, conditionally pathogenic easily penetrates into the deeper layers, and the presence of a weak immune system is able to trigger inflammation.
3. Endocrine.Candida colpitis often accompanies diabetes and thyroid disease.
4. Immune: allergic and immunodeficiency diseases.Inflammatory diseases of the genital also negatively affect the local immunity.
5. Iatrogenic.Candida colpitis can trigger antibiotics, hormonal and immune modulators.
Symptoms and signs of Candida vaginitis
clinical picture of Candida vaginitis depends on several of the following factors:
- From the quantitative and qualitative composition of the vaginal microenvironment: violation of a proper balance between the lactic microflora and opportunistic microbes provoke a change of acidity and a pathological increase in fungalpopulations.Accordingly, the evidence of local dysbiosis, the brighter the clinic Candida vaginitis.
with mild dysbacteriosis vagina lactobacilli retain their protective properties and are able to limit the growth of fungi, interfering with their penetration into the deeper layers.However, to fully restore the microbial equilibrium can not, therefore, candida infection is in a "dormant" state where its presence does not cause clinical disease.This condition is called kandidonositelstvo.Candida carriers are not considered sick.
Reducing the number of lactobacilli and pH shift encourage the growth of fungi is not only available in the vagina opportunistic pathogens also begin to proliferate.To become a "stronger" undesirable microorganisms in the microbial associations merged in the future, they either begin to compete with mushrooms and replacing them, or, on the contrary, help to spread fungal infection in the vaginal epithelium.For example, when examining patients with acute candidiasis colpitis one in five found Trichomonas and gradnerelly.If the origins of Candida vaginitis is a mixed infection, disease picture will be brighter and have a variety of clinical symptoms.
- The state of the local and systemic immunity.A healthy immune system is able to independently prevent the spread of fungal infections and restore the microbial equilibrium.
- From concomitant endocrine diseases and dishormonal.
Acute candidiasis colpitis differs pronounced local symptoms.Characterized by complaints of moderate or heavy abnormal discharge white distinctive look: they resemble cottage cheese or sour milk.In addition to the cables patients are complaints pronounced itching in the vagina, worse in the evening and at night, after contact with water and during menstruation.The inflammatory process in vaginal epithelium may be associated with a lesion of the vulva, urethra (urethritis) and skin anogenital area.
During the inspection of the vagina revealed marked inflammatory process: the mucosa sharply hyperemic and covered with gray-and-white films, there are copious typical "cheesy" kind of a sour smell.
Acute candidiasis colpitis requires adequate and timely treatment.Otherwise, after the two months of the disease becomes chronic inflammation features.
Chronic candidiasis colpitis different stubborn, poorly amenable to treatment, recurrent course.Outside the worsening of the disease is asymptomatic, and in acute flows softly.Most patients worried about vaginal itching.Secretions may be white or have a "normal", slimy, look.During the inspection of the vagina is determined by the thinning of the epithelium (atorofiya) and slight signs of local inflammation: moderate hyperemia (can be omitted), and a small number of cables.
colpitis Candida in pregnancy often occurs in the acute form.Diagnosed mainly in the early stages or before birth.
addition to patient complaints and a visual inspection of the vaginal mucosa diagnosis of Candida vaginitis complementary laboratory studies.The discharge of the vagina revealed spores or mycelium yeasts, and their number indicates the form of the disease: the true candidiasis, asymptomatic carriage, a combination of fungal infection with trichomoniasis, or bacterial vaginosis gardnerellezom.
self-diagnosis of Candida infection often leads to undesirable consequences.The presence of specific "cheese" discharge and itching do sometimes indicate the presence of fungi in the vagina Candida, but not enough for setting a definite diagnosis.
delayed diagnosis and / or therapy incorrect provoke these negative effects of Candida vaginitis:
- develop a chronic form of the disease;
- stenosis (narrowing) of the vagina;
- damage to the local protection mechanisms and increase the risk of pelvic infections.
presence of fungal infection in pregnant women in combination with the weakening of the immune defense able to adversely affect pregnancy: to provoke an inflammation of membranes, increase the risk of untimely delivery.
consequences of Candida vaginitis eliminate much harder than cure acute inflammation.To avoid a negative scenario, you need time to see a specialist.
treatment of Candida vaginitis
Candida vaginitis treatment success depends on the form of the disease and the presence of an unfavorable background.As a rule, the best treatment gives good results for the first time emerged acute fungal infection, whereas chronic candidiasis colpitis cured is very difficult.
antifungal therapy may be carried out by local or systemic exposure to infection.Complex cases require Combined therapies.Treatment of Candida vaginitis candles is as effective as a system (with the help of tablets) therapy.
Despite the extensive range of antifungal drugs, making the right choice can be a doctor after examining the results of laboratory research.Women often prefer to be treated yourself, choosing the most publicized in the media medicine.Self-treatment of Candida vaginitis pills or suppositories, unfortunately, can only lead to the disappearance of subjective symptoms of infection (itching, burning, whites), but does not cure the disease itself.
name specific scheme and the timing of treatment, suitable for all, it is impossible, since they are selected individually.
treatment of Candida vaginitis tablets by using drugs Fluconazole, Nystatin, itraconazole, and their analogues.
treatment of Candida vaginitis candles are used more often, especially in the case of acute infection.Apply ketoconazole, miconazole, sertaconazole and their analogs.
colpitis Candida in pregnancy is subject to compulsory treatment.Due to the risk to the developing fetus in the early stages of treatment of Candida vaginitis pills is not carried out.
The effectiveness of the treatment is evaluated one week after its completion.Carried out by standard laboratory tests and examination of the vaginal mucosa.In the case of chronic Candida vaginitis control tests must be carried out in three consecutive cycles.The absence of symptoms, signs of inflammation of the vagina during the inspection and negative results for the presence of the pathogen in the laboratory study are the criteria of recovery.
Unfortunately, sometimes even the most thorough treatment of fungal infection does not guarantee the absence of recurrence of the disease.