Candidiasis urogenital organs (thrush) in men

Candidiasis urogenital organs (thrush) - lesions of the urogenital tract yeast fungi of the genus Candida.

Candidiasis refers to a deep systemic diseases leading to the development of sepsis, can cause damage to lungs, kidneys, digestive tract and other organs. Often the causative agent is logged by exogenous, although it is possible and endogenous infection. One of the manifestations of systemic deep candidiasis may be a lesion of urinary organs. But most of all-the clinical forms of candidiasis are superficial lesions, usually in a limited area of the genital organs. The possible sexual route of transmission, although it is not the primary.

The cause of the disease in the first place, is the species C. albicans, and less frequently C. tropicalis and C. krusei. C. albicans (albicans - whitish, shiny (lat.) - is the most common, with the most pronounced pathogenic properties among all the causative agents of candidiasis.

Candida fungi are widely distributed in nature, live on household items, food products, primarily on the wealthy sugars from fruit and vegetables. They quickly and easily colonize the skin and mucous membranes of humans, bordering with the external environment, including the mucous membranes of the oropharynx, nose, digestive and urogenital tracts. According to many authors, Candida fungi are Associaton normal microflora of the human body, therefore they quite often appear in crops with a healthy mucous membrane of the urethra, vagina and urine culture.

Under certain conditions saprofitiruyuschem Candida fungi can acquire pathogenic properties. In such cases, being at a healthy mucous membrane of single or small elements of the fungus begins to multiply rapidly, forming multiple filamentous forms (pseudomycelium). Indicator parasitic activity of excitation is the rapid formation of filamentous forms of the fungus. The cells of the fungus with new pathogenic properties are attached to the epithelial cells of the mucous membranes, primarily to cells rich in glycogen. Then highlighted them and parasites in the cytoplasm and nuclei, gradually destroying the host cell and forming lesions of the mucosa.

Mushrooms produce endotoxin and a number of proteolytic, lipolytic and saccharolytic enzymes. The action of these enzymes is due to a number of clinical symptoms, in particular, intense itching vaginal candidiasis, is caused by the breakdown of carbohydrates in the epithelial cells of the vaginal mucosa in acetic, formic and pyruvic acid, irritants are abundant nerve endings.

The main causes of candidiasis (yeast infection) in men
Although the causative agents of candidiasis can be transmitted sexually, in most cases candidiasis is not associated with sexual intercourse. Candidiasis is not related to sexually transmitted diseases and being seen with them because of their similar clinical picture.

The factors contributing to the development of candidiasis:
- Congenital or acquired immunodeficiency (HIV-infection).
- Receive broad-spectrum antibiotics.
The General weakening of the immune system (due to abrupt climate change, extreme emotional distress).
- Endocrinopathy (primarily diabetes).
- Common infections and intoxications.
- Violation of homeostasis and normal microbial balance of the mucous membranes of a person (dysbiosis) under the influence of endogenous (stress, local infection) and exogenous (corticosteroid hormones, antibiotics, cytostatics).
- Weakening of local tissue resistance and violation of protective mechanisms of the mucous membrane: local trauma (mechanical, thermal, chemical), maceration, impaired slizeobrazovanie glandular epithelium in chronic use or concomitant acute inflammation of the genital organs.

Epidemiology of candidiasis urogenital in men.

In men, the development contributes to candidiasis, often exogenous contamination, and selected strains of the fungus often have high pathogenicity.

Candidiasis of the penis affecting men after sexual contact with a woman suffering from Candida vaginitis, has a second name - "marital thrush".

Because the skin and mucous membranes of the genital organs of healthy people have high contamination by fungi of the genus Candida, we can not exclude endogenous infection, as well as the introduction of the agent with other parts of the skin and mucous membranes, especially of the rectum. So the transmission due to anal sex from men and the infection from the anus are the reason for the initial infection of the vagina or re-infection after treatment.

In patients with candidiasis of the genitals of men mostly identified only by local factors violations of the resistance of normal mucous membranes (other urogenital infections).

Clinically, candidiasis genital organs in men can manifest in the form of the following diseases.

Balanitis - superficial candidiasis of the penis is the most common form of candidiasis genital organs in men. Most of all he has a sexual origin. Depending on the extent of damage of the skin and mucous membranes it can occur in three clinical forms: with the formation of erosions, film, bright-red spots and bubbles. In addition, the skin of the penis may appear mottled, scaly lesions redness and attemptable rashes. In the process may involve the thigh muscle, inguinal folds and perianal region. Most often affects the glans penis and foreskin, and then the skin of the body of the penis, on the third place - inguinal region, at last - the skin of the scrotum.

Most often on the head of the penis at the coronal sulcus and inner foreskin of marked redness, light swelling and infiltration of the skin. Areas of maceration covered with white-gray patina, after the removal of which reveals a red erosive surface. At the head of the penis are small superficial erosions, and on the inner foreskin of - whitish pseudobinary plaque. The foreskin becomes infiltrated, bad and painful tensile, sometimes with cracks on the edge. Inflammatory changes are accompanied by itching and burning. When erased during Candida balanitis there are only slight hyperemia of the coronary sulcus and the cluster of white poroshkovaya masses under the inner leaf of the foreskin, or small papules and microerosion.

When the chronic balanoposthitis due to the appearance of cracks on the edge of the foreskin and subsequent scarring can occur narrowing of the foreskin with the formation of persistent phimosis. Rare complications in the form of gangrenosa penis, lymphangitis, lymphadenitis, or causing vegetations, candidography.

Candidal urinary tract infection (candidal urethritis) is rare (0,3-3,5 all patients suffering from inflammatory diseases of the urethra neonorange nature). Clinical manifestations it is similar to gonorrhea, but more often it occurs less acute. The incubation period from 4 days to 2 months, usually 2-3 weeks.

When inflammation of the bladder (cystitis) in a patient having a feeling of heaviness in that area, pain often occurs more frequent urination. Urine becomes turbid, it may be an admixture of blood.

Diagnosis candidiasis (thrush) genitals in men, based on a characteristic clinical picture and disease course, must be confirmed by the identification of fungi of the genus Candida in the preparations of pathological material in direct microscopy. Identification of fungi of the genus Candida at sowing, the method of direct immunofluorescence (DFA) and by DNA-diagnostics (PCR) has no diagnostic value, as with candidiasis, it is important not just the presence and the number of fungi of the genus Candida. In a small number of these fungi are present in the mouth, vagina, and the colon of most healthy people.

There are many drugs for the treatment of candidiasis in men. Some are used topically (cream), others orally (tablets or capsules for oral administration).

When candidal balanoposthitis (lesion of the glans penis and foreskin) enough local treatment. Apply the cream with clotrimazole. It put a thin layer on the head of the penis and the foreskin 2 times/day for 5-7 days.

Possible single dose of fluconazole, 150 mg orally, but usually this is not necessary. Commercial name fluconazole – Medoflucon, Diflazon, Diflucan Mycosyst, Forkan, Flucostat.

Treatment of recurrent vaginal candidiasis

If the recurrence of fungal infection occur in women, this is a serious reason for screening for endocrine and other chronic diseases. It is important to consider the fact that chronic genital candidiasis usually affects the nearby organs and systems of the body, the bladder, the intestines.

Therefore, to achieve full recovery and prevent re-infection you need to take antifungal drugs not only locally, but also inside. Treatment of patients with chronic forms presents considerable difficulties. Treatment failure may be related to inadequate dosage and duration, as well as individual sensitivity to one or another group of antifungal drugs.

It is therefore necessary to carry out bacteriological tests (crops) with the definition of sensitivity to antifungal drugs. Note that mushrooms have the ability to adapt quickly and form a resistance to the medications applied.

If recurrent yeast infections (more than 4 exacerbations during the year), the following treatment options:
- Fluconazole (Medoflucon, Diflazon. Diflucan Mycosyst, Forkan, Flucostat) 100 mg orally 1 time a week for several months.

A good way to prevent the growth of fungi is the use of yogurt containing live lactic culture, as well as the use of natural products that possess good antifungal activity, such as garlic, propolis, hot red pepper, berries and leaves of bilberry, juice and seeds of grapefruit, walnut leaves, tea tree oil.

Venereal diseases
Urologist