Chronic mucocutaneous candidiasis
Description, Causes and Risk Factors:
A group of immunodeficiency disorders primarily of T cell function characterized by persistent Candida infection of the mucous membranes, skin, scalp, and nails.
Chronic mucocutaneous candidiasis is the term used to describe a rare, heterogeneous group of syndromes in which affected individuals with congenital, endocrinological or immunological disorders develop recurrent or persistent mucosal, cutaneous or nail infections with Candida albicans. Chronic mucocutaneous candidiasis is associated with endocrine conditions like hypoparathyroidism, hypothyroidism, hypoadrenalism and diabetes mellitus. Immune defects i.e. malfunctioning of lymphocytes, low levels of immunoglobulin is also a contributory factor.
It affects males and females equally.
Although no characteristic immune system defects are known to cause this infection, allergy may play a role. Many patients have a diminished response to various antigens or to Candida organisms alone. In some patients, allergy may result from deficient microphage inhibitory factor, a mediator normally produced by lymphocytes. This leads researchers to think that the disease may result from an inherited defect in cell-mediated (T-cell) immunity.
Recent studies suggest that there is alteration in production of cytokines in response to candida antigens. These include decreased interleukin-2 (IL-2) and interferon-gamma levels and increased interleukin-10 (IL-10).
Hypoparathyroidismand adrenal failure are the most common endocrineabnormalities associated with chronic mucocutaneous candidiasis.
Other infectionslike dermatophytosis, herpes simplex and disseminatedmycobacterium avium infection are also reported tocoexist with chronic mucocutaneous candidiasis.
Gastrointestinal andhematological dysfunctions are sometimes associatedwith chronic mucocutaneous candidiasis.
Chronic mucocutaneous candidiasis infections seldom produce systemic symptoms, but in late stages may be associated with recurrent respiratory tract infections.Symptoms may also be included hoarseness, dysphagia, and hemoptysis. There is poor correlation between oral lesions and laryngeal involvement.
General symptoms may include:
Mouth - blisters and oral thrush.
Skin - scaly, red rash often in the vaginal area.
Eyes - infection of the cornea and eyelids.
Fingernails - nails may split and discolored.
Diagnosis is based on presence of recurrent candidal skin or mucosal lesions in the absence of known causes of candidal infection.
Microscopy and culture of skin swabs and scrapings confirm the presence of organisms.
Most patients with chronic mucocutaneous candidiasis are treated with chronic antibiotics that are specific for fungal infections. Treatment comprises topical antifungal treatment which is insufficient, systemic antifungal treatment which is often followed by a rapid relapse, and specific immunotherapy with live tissue or transfer factor. Combination of systemic antifungal therapy and immunotherapy seems to be the most promising approach. However, no permanent cure has so far been achieved.
Patients should be evaluated periodically for endocrine disorders and those endocrine disorders should be treated as necessary.
Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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