Fungi and Disease

Some Topics

Candida Yeasts

Candida is a symbiotic yeast, which lives in us and on us, as part of our normal collection of microorganisms; everyone has lots of them. The genus Candida includes approximately 154 species, Yeasts overgrow when conditions are right for them and they can be a nuisance. You cannot get rid of all resident yeasts. You hope to find an ecological balance, with yeast growing at a controlled rate, below the symptom-producing level Candida albicans is most often isolated from the skin, mouth and vagina. Candida is the most common cause of opportunistic invasive fungal infection in immune compromised hosts. Six species cause most human infections.

Vaginitis Candida overgrowth is a common cause of vaginitis in women. Vaginitis is often provoked or aggravated by sexual intercourse. In one study, female risk factors for recurrent vulvovaginitis were recent masturbation with saliva , recent cunnilingus and ingestion of two or more servings of bread per day. A male risk factor associated with recurrence in his partner were masturbation with saliva in the previous month. Many woman suffer prolonged and mysterious vaginal irritation and pelvic pain. Infection is always assumed, and repeated treatment for candida and other organisms often fails. Seldom is the diagnosis of vaginal allergy considered. The vagina often reacts to contact allergens and to circulating food allergens with increased mucus production and secondary candida overgrowth. Milk allergy, for example, commonly triggers vaginitis in both children and adults

Prostaglandins in male semen, and allergic responses to semen and/or sperm may be important contributors to vaginitis in sexually active women.. Wilkins, from Cornell, reported that Candida overgrew in the vaginas of women whose immune response was suppressed by prostaglandin E2. Ibuprofen, a prostaglandin inhibitor, improved the anti-Candida response. Prostaglandins were originally discovered in, and named for, secretions of the male prostate gland. Male semen prostaglandins may, in some couples, inhibit the woman's local immune defense. Sometimes, semen proteins or sperm excite female antibody production and trigger allergic, inflammatory responsesVaginal candida overgrowth, as everywhere else, is a symptom of another pathological process, and not a cause of it. While treatment of vaginitis with oral and/or vaginal lactobacillus is popular, no benefit has been demonstrated. Men may be troubled by yeast overgrowth on their penis and on the skin around the anus. Yeast overgrowth in the groin is the cause of "jock itch".

Babies often have Candida overgrowth on the diaper area of their skin, producing the most aggressive from of "diaper rash". This is often seen in food allergic infants - cows milk allergy is the most common cause. Oral growth of Candida is known as "thrush" and is also common in babies. Infants with inborn errors of amino acid metabolism display prominent thrush.

Candida is irritating and is perceived as whitish surface material associated with local inflammation and itching or burning. A typical sickly-sweet odor may be obvious. Vaginal candida overgrows in response to local changes in microbial flora and immune defense induced by oral contraceptive and antibiotic use. It is common in diabetics with elevated sugar in their secretions, since yeast, like Candida, thrive on glucose. Diabetics with elevated body sugar concentrations do suffer candida overgrowth on the skin, especially in the groin and perianal areas.

Antibiotic use damages the ecology of microorganisms in the bowel and on body surfaces, permitting the overgrowth of Candida, and undesirable bacteria. It is reasonable to take oral Nystatin in association with broad-spectrum antibiotics. Tetracycline, an antibiotic which often promotes Candida growth, has been marketed in a capsule which contained Nystatin. Avoidance of antibiotic usage is an even better strategy, especially when antibiotics are often used to treat conditions for which they offer no benefit (allergy, colds and other viral infections).

Danger with Immune Deficiency Opportunistic growth of candida occurs in people with defective immunity, and can be life-threatening Candida albicans is the most common fungal pathogen among immune-compromised, hospitalized patients, accounting for roughly 50-60% of all bloodstream fungal isolates. Candida species are an important cause of infection in intensive care units increased by 207% from 1979 to 2000. Risk factors include chemotherapy, organ transplants, abdominal surgery, central vascular lines, often used in ICU patients; the use of multiple or broad-spectrum antibiotics; total parenteral nutrition (TPN). The incidence of candida infection increases the longer a patient stays in hospital with peak incidence of infection around day 10.

 See Hospital Infections.

Fungi Everywhere

A profusion of fungi exists in the environment. Some fungi are able to cause an invasive infection in otherwise healthy individuals. Other fungi are opportunistic fungi that become invasive when immune defenses are compromised. Diagnosis of fungal infection is difficult. There are many problems when you try to connect a test result to a disease. Fungi are so abundant and there are so many varieties in every environment that it is seldom easy to pick just one cause among many. Fungi are inhaled and ingested. Foods always contain fungal spores and actively growing molds. Attempts to culture fungi often fail; only a small number grow in the culture media commonly used. Some new methods of detecting fungal DNA may be useful but development of reliable tests is slow and expensive.

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