mukokutan kandidiasis
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Noorahmah Adiany Ansari 110 207 005
Eko Wahyuddin S 110 208 063
Counselor supervisor : dr. A.M.Adam, Sp.KK (K)
Adviser : dr. Sari Handayani P.
MUCOCUTANEUS CANDIDIASIS
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DEFINITIONCandidiasis is a fungal disease, which is acute or subacute
caused by Candida species usually by the species Candida
albicans, and can affect the mucous membranes, skin, nails,
GI tract, and can also infect the organ in systemic.
The synonim of Candidiasis are Candidosis or Moniliasis
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EPIDEMIOLOGYCandidiasis disease found worldwide, can affect all ages, both male
and female. Candidiasis also associated with predisposing factors
endogenous and exogenous
predisposing factors
pregnancy, obesity,
Endokrinopati,
Contact with patients with
sexually transmitted diseases
Chronic Disease
AGE
Temperature and high humidity,
Hygiene of skin
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ETIOLOGYCandida albicans is the yeast in the oval size 2-6
× 3-9 μM that can produce stem cells,
pseudohyphae, and true hyphae.
Figure 1. Candida in Pottasium hydroxide preparation.
Pseudomycelia in clusters of grape-like yeast cells
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CLASSIFICATION
Classification of Candidiasis infection based on the
site of predilection which is on mucocutan candidiasis,
systemic candidiasis, cutis candidiasis, and chronic
mucocutaneus candidiasis.
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CLASSIFICATION continue…Based on an exposed spot, Conant et al (1971) share as a local
candidosis which can be distinguished clinically:
Candidiasis of mucous membranes (mucocutaneous):
1. Oral candidiasis (thrush)
2. Perleche
3. Vaginalis candidiasis (vulvovaginitis)
4. Balanitis or balanopostitis
5. Chronic mucocutaneous candidiasis
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predisposing factors
C. albicans penetrate the mucosal epithelial
cells
decreased immunity
Blastospora develop into hyphae and pseudo-hyphae apparent pressure from the
tissue damage, so the invasion into the tissue can
occur.
C.Albicans invasion into the tissue
holding the patient's body
Attachment of microorganisms in the host cell tissue
Tissue damage
supported by molecular enzymes of candida albicans
PATHOGENESIS
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Oral Candidiasis (Thrush).white looks gray pseudomembrane that covers
the tongue, palate mole, inner cheek, and other oral cavity surfaces
Figure 2. Oral candidiasis: thrush Extensive cottage cheeselike plaques, colonies of Candida (pseudomembranous), Patches of erythema between the white plaques represent erythematous (atrophic) candidiasis.
CLINICAL MANIFESTATION
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PerlecheLesions in the form of fissures or cracks in the skin
at an angle of mouth; lesions underwent maceration, erosion, wet, and basically erythematous.
Figure 3. Candida perleche with erythema and fissuring at the corners of the mouth.
CLINICAL MANIFESTATION continue…
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Vulvovaginitis. white patches on erythematous mucosa erosive, ranging from
the cervix to the introitus vagina, and especially the vagina 1/3 bottom. the lump apart from the mass of the vulva or vagina wall is composed of necrotic material, epithelial cells, and fungi.
Figure 4. Vulvovaginal candidiasis. Figure 5. Vulvovaginal candidiasis. White patches appear on the White patches appear on theerythematous mucosa in the labia major erythematous mucosa in the cervixand minor
CLINICAL MANIFESTATION continue…
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Balanitis or balanopostitiswhite patches on the membrane of the glans penis is often entirely become erythematous and erosive
Figure 6. candidiasis : balanoposthitis. Figure 7 .Erythema and white plaques several discrete pustules on the glans seen on the glans penis penis and in the prepusium. and prepusium
CLINICAL MANIFESTATION continue…
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Chronic mucocutaneous candidiasis. This disease arises because of the lack of leukocyte function or hormonal systems, usually found in patients with a variety of genetic deficiency, generally found in children - children.
Figure 7. Mucocutaneous candidiasis of the scalp of patients with chronic.
CLINICAL MANIFESTATION continue…
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1. Anamnesis and Physical Examination
2. Direct examination.Mucocutaneous swabs examined with 10% KOH solution or by Gram staining : yeast cells, blastospora, or pseudo hyphae.
Figure 8. Candida albicans: KOH preparation: Budding yeast forms and sausage-like form of pseudo hyphae
.
DIAGNOSIS
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2. Examination of culturesMaterial to be examined in order to be planted in
Sabouraud dextrose glucose, can also be affixed to these antibiotics (chloramphenicol) to prevent bacterial growth.
Figure 9. Colonies of Candida albicans.
DIAGNOSIS continue….
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1. Oral Candidiasis (Thrush)
Leukoplakia is a clinical term
that refers to an oral mucosal
white patch that will not be
contagious.
Figure 10. Hairy leukoplakia appears as a broader and plaques on the lateral folds of the tongue
DIFFERENTIAL DIAGNOSIS
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2. Trichomonas vaginalis
Vulvovaginitis with vaginal secretions
There is a yellow-green secretions,
smells bad and frothy, vaginal walls
are reddish, and there are strawberry
appereance of the cervix.
Figure 11. This patient presented with a "strawberry cervix" due to a Trichomonas vaginalis infection, or trichomoniasis. The term "strawberry cervix" is used to describe the appearance of the cervix . The cervical mucosa reveals punctate hemorrhages along with accompanying vesicles or papules.
DIFFERENTIAL DIAGNOSIS continue…
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2. Lichen Planus
lichen planus occurs mainly on
the buccal mucosa, often
bilateral, and sometimes on the
tongue dorsal or lateral.
Figure 12. Oral Lichen planus
DIFFERENTIAL DIAGNOSIS continue…
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1. Avoid or eliminate the predisposing factors.
2. Topical
3. Systemic
MANAGEMENT
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Leukoplakia patients can be a squamous carcinoma,
although rarely.
Patients with AIDS oral candidiasis, chronic
mucocutaneous candidiasis, can be an esophageal candidiasis.
Candidiasis Vulvovaginalis or who have chronic
Candidiasi Vulvovaginalis can lead to chronic dyspareunia to
disrupt the marital relationship.
COMPLICATIONS
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Prognosis of mucocutaneous candidiasis is
generally good and depends on the severity of
the predisposing factors.
PROGNOSIS
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THANK YOUSpecial thanks to our supervisor and
adviser