Candida

See also: candida in short

Introduction

Fungal Infections and Immune System

Candida is a fungus, or mycete.

Man is constantly exposed to fungi. Most tolerate this exposure without consequences. There are at least two reasons that explain the phenomenon: first, immunocompetent subjects (ie with a normally functioning immune system), have a high level of innate resistance to colonization by fungi; second, most fungi have little intrinsic virulence (they are poorly aggressive).

However, in conditions that lead to host debility, many subjects become susceptible to fungus, including candida. If the infection is not diagnosed early and treated aggressively, and if the underlying conditions that cause the host to be weakened are not kept under control, the fungal infection can become lethal.

These infections, once considered rare and exotic, have now become more common and medically important. This is due to the acquired immunodeficiency syndrome (AIDS), the increased use of radio and chemotherapy for the treatment of patients with malignant tumors and for the use of suppressive drugs of the immune system (immunosuppressants) in the prevention of rejection after transplantation. 'organ. Because these fungi become pathogenic (they cause disease) when the host is in a state of debility, they are commonly called opportunistic fungi .

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Candida albicans

Candida normally lives as a commensal in many districts of the human body in the form of yeast (a micro-organism formed by a single cell). By commensal we mean an organism (in this case the fungus) that lives in close relationship with another organism (the human body) and that benefits from it without the human body itself having either benefits or disadvantages. If it is not pathogenic, it is always in the form of yeast, both at 37 ° C, which is the temperature of the human body, and at room temperature. When it becomes pathogenic, it emits extroflexions from its membrane and becomes an Ifa (that is, it has branches or filiform filaments that stretch at their apex); it has the ability to "hang" on the underlying tissues, and becomes an opportunist, that is, it takes advantage of a situation of immunodepression to proliferate in an exaggerated manner and provoke candidiasis. In this case it is also called a parasite, that is, an organism that lives above or within a host and from which it benefits without giving any useful contribution in return, or even causing damage to the guest. In some internal organs, always as an opportunist, candida can also anchor itself in the form of mycelium (that is, a whole diife), which is synonymous with mold .

Candidiasis

Candidiasis (or candidiasis) is the most frequent mycosis (fungal infection) and constitutes one of the most important problems of the immunocompromised subject. Clinically, it can give superficial infections, skin and mucous membranes, deep infections and generalized infections . The genus Candida includes about 150 species, of which about ten are potentially pathogenic for humans. Among them, the main one is Candida albicans ; Candida tropicalis, Candida Krusei, Candida guilliermondi, Candida parapsilosis, Candida stellatoidea, Candida glabrata and others are also responsible for human infections. All these, in particular Candida albicans, are part of the normal microbial flora of man and are found on the healthy mucous surfaces of the oral cavity, vagina, gastrointestinal tract and rectal area. Up to 80% of the population can present colonization of these sites in the absence of disease. On the contrary, the organism is rarely found on normal human skin, with the exception of some areas called intertiginose, that is those juxtaposed skin surfaces such as the armpits or the groin. Under certain conditions, for example when the mucous membranes are damaged due to inflammation secondary to chemotherapy or when intravenous catheters or syringes are contaminated, these microorganisms reach the blood stream and are taken to organs such as the lung, spleen, liver, kidneys, heart, brain and eyeball. In all these locations, Candida can cause infections.

Skin lesions can occur in 10-30% of patients who have disseminated infections.

Causes

The underlying conditions that cause Candida, from a normal diner, to turn into an opportunistic parasite, are all those situations that determine an immunosuppression of the subject, therefore a deficit of the function of the immune system:

• Mechanical causes : traumas or occlusions; burns; uses of intravascular or urinary catheters.
• Drugs : antibiotic therapies, especially for long periods and with broad-spectrum antibiotics; estroprogestinic contraceptives, which alter the normal vaginal bacterial flora; immunosuppressive drugs used as anti-rejection therapy in transplant patients; intravenous drug abuse.
• AIDS; autoimmune diseases (Lupus, rheumatoid arthritis, Sjiogren's syndrome and others); endocrine diseases (hypoparathyroidism, hypoadrenalism, hypothyroidism); diabetes mellitus; vitamin deficiencies; pregnancy; premature birth.