A REVIEW ON CANDIDIASIS: TYPES AND MEDICATIONS

 

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ABOUT AUTHORS:
V. Sravanthi*1, Mayure vijay kumar1, Donthineni Kalyan2, C.P.Meher1, G.J.Finny1
1Department of pharmaceutical chemistry, Maheshwara College of Pharmacy
2Department of Pharmaceutical Analysis, Saraswathi College of Pharmaceutical Sciences.
Isnapur chitkul ‘X’ road, Patancheru, Hyderabad-502307
*v.sravanthi27@gmail.com

ABSTRACT:
Candida albicans are the most effective organism that makes quite an yeast infection to form a inflammation in the different parts of the body like oral, vaginal, hepatic, renal etc…, During the infection of Candidiasis there are less chances of human death can occur, but in patient with damaged immune systems there is a chance of death, but to the Candidiasis flow to the blood streams and kills. In this review the full outline of the Candidiasis and the types and medication are put forth to be aware on the diseases caused by Candidiasis. According to FDA approval, the Ketoconazole is the first-line drug used for the treatment of the different types of Candidiasis.

REFERENCE ID: PHARMATUTOR-ART-2232

PharmaTutor (ISSN: 2347 - 7881)

Volume 2, Issue 9

Received On: 14/06/2014; Accepted On: 25/06/2014; Published On: 01/09/2014

How to cite this article: V Sravanthi, VK Mayure, K Donthineni, CP Meher, GJ Finny; A Review on Candidiasis: Types and Medications; PharmaTutor; 2014; 2(9); 36-45

INTRODUCTION:
The following are the two types of Candidiasis that are spreading in the current disease conditions.

I) MUCOSAL CANDIDIASIS:
Opportunistic pathogens of the genus Candida is named as Mucosal candidiasis. Were it can be discussed as in two name mucosal and disseminated candidiasis1. According to oral, oesophageal or vaginal infections, is common in HIV/AIDS Mucosal candidiasis which varies from 7-93% infection2. The disseminated candidiasis named as a remarkably uncommon in AIDS. due to relatively adequate neutrophil function in most HIV-infected individuals.

RISK FACTORS: Neutropaenia, Parenteral nutrition, Abdominal surgery, Broad spectrum antibiotics, Cancer and corticosteroid use3,4

The following are the types of candidiasis that are related to the mucosal candidiasis:
Oropharyngeal Candidiasis:
The fungal infection of Candida species  of mycosisca uses the oral candidiasis. In the presence of Candida albicans were the half the population are caused by these candidiasis5.

Pseudomembranous Candidiasis:
It is also a class of oral candidiasis referred as trush. Around 35% of candidiasis are come across these category. Sometimes there will be an occurance of bleeding beneath the mucosa as named as "curdled milk", the location of pseudomembranous candidiasis occurs on the tongue, buccal mucosae or palate6.

The following are the cases that come under pseudo membranous Candidiasis:

Vaginal candidiasis

Vaginal candidiasis is an infection of the vagina involving overgrowth of a yeast, or fungus, known as Candida.Over one million women are suffering with this type of candidiasis

Oral candidiasis


Oral candidiasis known as thrush, causes white, curd-like patches in the mouth or throat

Deep organ candidiasis


Candidiasis is a serious systemic infection that can affect the esophagus, heart, blood, liver, spleen, kidneys, eyes, and skin.

Erythematous Candidiasis:
The type of candidiasis which appears as a red, raw-looking lesion is assayed as Erythematous (atrophic) candidiasis. Sub-types of Erythematous candidiasis are denture-related stomatitis, angular stomatitis, median rhombiod glossitis, and antiobiotic-induced stomatitis7. Two types of candidiasis can be studied as:
The candidiasis occuried in the dorsum of the tongue in persons taking long term corticosteroids or antibiotics is called as Acute erythematous candidiasis. This is usually termed "antibiotic sore mouth", "antibiotic sore tongue",8 or "antibiotic induced stomatitis" because it is commonly painful as well as red. Chronic erythematous candidiasis is more usually associated with denture wearing (see denture-related stomatitis).

Hyperplastic Candidiasis:
According to candidiasis, it is formation of white patch on9 the commissures of the oral mucosa were behaved as variant of oral candidosis. The major etiologic agent of the disease is the oral fungal pathogen Candida predominantly belonging to Candida albicans, although other systemic co-factors, such as vitamin deficiency and generalized immune suppression. Lesions are the major formation in this type of candidiasis, if untreated it demonstrate dysplasia and develop into carcinomas, all this conditions are occurred in the Chronic hyperplastic candidosis/candidiasis. According to cernea et al, many oral leukoplakias are associated with Candida infections10. chronic mucocutaneous candidal lesions, encountered in patients with endocrine and immune defects, and affecting the skin and other mucosae, were also described by some as chronic hyperplastic candidosis. The Group I lesions consist of the classic triad—pseudomembranous, erythematous, and hyperplastic variants11.

Denture Related Stomatitis:
Denture sore mouth/ chronic atrophic candidiasis/ denture-associated erythematous stomatitis is a common condition where mild inflammation and redness of the oral mucous membrane occurs beneath a denture. common form of oral candidiasis (a yeast infection of the mouth). It is more common in elderly people. The following are the types of Denture related stomatitis12-15:

· Type 1 - Localized inflammation or pinpoint hyperemia.
· Type 2 - More diffuse erythema (redness) involving part or all of the mucosa which is covered by the denture.
· Type 3 - Inflammatory nodular/papillary hyperplasia usually on the central hard palate and the alveolar ridge.

Angular Stomatitis:
Inflammation of the corners of the lips is termed angular stomatitis or angular cheilitis.
· Children = repeated lip-licking.
· Adults = iron deficiency anemia, or vitamin B deficiencies
· Areas: jaws

According to this type of candidiasis, the skin folds around the angle of the mouth which are kept moist by saliva, which in turn favours infection; mostly by Candida albicans or similar species16Medications: nystatin, etc;

Median Rhomboid Glossitis:
Central papillary atrophy is the other name of Median rhomboid glossitis here condition characterized by an area of redness and loss of lingual papillae. Area: dorsum of the tongue, circumvallate papillae17-19

Candidal Vulvovaginitis(CV):
It Is the another type of candidiasis caused by candida albicans which causes infection to the vaginal mucosa membranes. Disease can be identified by vaginal itching or pain, burning with urination etc., it is also known as Vaginal thrush. The main reason to cause Candidal vulvovaginitis was hormonal imbalance. clotrimazole and fluconazole are used in the severe treatments20-23.

75%= Affected by CV
5%
= Recurring episodes

Candidal Balanitis: Inflammation in the Glans refer to the Candidial Balanitis, 

RISK FACTORS:
· Uncircumcised penis
· Antibiotic use
· Corticosteroid use
· Immunocompromised
· Poorly controlled diabetes

DRUGS: Clotrimazole, Miconazole, Anticoagulants24-26.

Esophageal Candidiasis (Candid esophagitis):
It is an esophagus inflammation, caused by immune compromised states, also called as monilial esophagitis.27,28

DRUGS: nystatin, itraconazole, caspofungin, amphotericin etc…,

Candidal Intertrigo:
Inflammation between intertriginous folds of adjacent skin is known as Candidal intertrigo. Intertrigo is also a known symptom of vitamin B6 deficiency29.
DRUGS:
fluconazole, griseofulvin, and nystatin.

Candidal Paronychia:
Infection of nails and skin are known as candidal paronychia.
Sudden infection =  Acute paronychia
Gradual infection = 
Chronic paronychia30-32
DRUGS:
clindamycin or cephalexin

Perianal Candidiasis:
It is the another type of skin infection present as pruritus anicaused by Candida albicansand named as Perianal candidiasis.33

Chronic Mucocutaneous Candidiasis:
An immune disorder of T cellsis Chronic mucocutaneous candidiasis. It is caused by also other type of infection called human papilloma virus34.

Congenital Cutaneous Candidiasis: Also known as Beck-Ibrahim disease, occurs in newborn babies caused by premature rupture of membranes35

Erosio Interdigitalis Blastomycetica: Infection extends on the sides of fingers36.

Onychomycosis :Nail infection, "tinea unguium.
This condition may affect toenails or fingernails, 10% of the adult population are suffered with Onychomycosis37

Distal subungual onychomycosis= Tinea unguium
White superficial onychomycosis
=  10 percent of onychomycosis
Proximal subungual onychomycosis
=  Tinea unguium
Candidal onychomycosis
=  Damage of the nail38,39

Invasive Candidiasis: Invasive candidiasis is a fungal infection that can occur when Candida yeasts enter the bloodstream.

II) DISSEMINATED CANDIDIASIS:
Antibiotic Candidiasis
 (iatrogenic candidiasis):
It is a Candidal infection caused by antibiotic use.like overuse of broad-spectrum antibiotics, which are used for control of body pains.40,41

Genitourinary Tract Candidiasis:
It is common fungal infections which lead to life-threatening invasive to non-life-threatening mucocutaneous diseases. Species involved are Candida spp.,Candida albicans42,
Nongenitourinary candidiasis
=          Oropharyngeal manifestations
Genitourinary candidiasis
=           Vulvovaginal candidiasis43

Renal Candidiasis:
Upper urinary tract that involves the renal pelvis and medulla related to Primary renal candidiasis. Species involved was Candida pyelonephritis, untreated disease may gradually progress to fungus ball (mycetoma) or abscess formation44,45.

Candidemia:
Candida albicans and Candida parapsilosis are the two most frequent causes of candidemia in pediatric patients.46
DRUGS:
fluconazole, an echinocandin, amphotericin B

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