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The genus Candida encompasses more than 150 species Clay Matthews Jersey , only a few of which cause disease in humans. With rare exceptions, the human pathogens are C. albicans, C. krusei, C. parapsilosis, C. tropicalis, and C. glabrata.
These organisms are found on inanimate objects Aaron Rodgers Jersey , in foods, and on animals and are normal commensals of humans.
They inhabit the gastrointestinal tract including the mouth and oropharynx, the female genital tract, and the skin.
Although cases of candidiasis have been described since antiquity in debilitated patients, the advent of Candida species as common human pathogens dates to the introduction of modern therapeutic approaches that suppress normal host defense mechanisms.
With the introduction of antifungal agents, the causes of Candida infections shifted from an almost complete dominance of C. albicans to the common involvement of C. glabrata and the other species listed above.
The non-albicans species now account for approximately half of all cases of candidemia and hematogenously disseminated candidiasis.
Recognition of this change is clinically important Bart Starr Jersey , since the various species differ in susceptibility to the newer antifungal agents.
In developed countries, where medical therapeutics are commonly used, Candida species are now among the most common nosocomial pathogens.
Candida is a small, thin-walled, ovoid yeast that measures 4-6 micrometers in diameter and reproduces by budding.
Pathogenesis
In the most serious form of Candida infection, the organisms disseminate hematogenously and form micro abscesses and small macro abscesses in major organs. Although the exact mechanism is not known David Bakhtiari Jersey , Candida probably enters the bloodstream from mucosal surfaces after growing to large numbers as a consequence of bacterial suppression by antibacterial drugs; alternatively, in some instances, the organism may enter from the skin.
PREDISPOSING FACTORS:
Numerous reviews of cases of hematogenously disseminated candidiasis have identified the following predisposing factors or conditions:
聲 Antibacterial agents
聲 Indwelling intravascular catheters
聲 Hyper alimentation fluids
聲 Indwelling urinary catheters
聲 Parenteral gluco corticoids
聲 Respirators
聲 Neutropenia
聲 Abdominal and thoracic surgery
聲 Cytotoxic chemotherapy
聲 Immunosuppressive agents for organ transplantation.
聲 Patients with severe burns
聲 Low-birth-weight neonates
聲 Persons using illicit IV drugs are also susceptible.
聲 HIV-infected patients with low CD4+ T cell counts
聲 patients with diabetes
These patients are susceptible to mucocutaneous infection, which may eventually develop into the disseminated form when other predisposing factors are encountered.
Women who receive antibacterial agents may develop vaginal candidiasis.
Clinical Manifestations
Mucocutaneous Candidiasis
Thrush is characterized by white, adherent, painless Dexter Williams Jersey , discrete or confluent patches in the mouth, tongue, or esophagus, occasionally with fissuring at the corners of the mouth.
This form of Candida disease may also occur at points of contact with dentures.
Organisms are identifiable in gram-stained scrapings from lesions
. The occurrence of thrush in a young, otherwise healthy-appearing person should prompt an investigation for underlying HIV infection.
More commonly, thrush is seen as a nonspecific manifestation of severe debilitating illness.
Vulvovaginal candidiasis is accompanied by pruritus Jace Sternberger Jersey , pain, and vaginal discharge that is usually thin but may contain whitish "curds" in severe cases.
Other Candida skin infections include
1. Paronychia, a painful swelling at the nail-skin interface
2. Onychomycosis, a fungal nail infection rarely caused by this genus
3. Intertrigo, an erythematous irritation with redness and pustules in the skin folds
4. Balanitis, an erythematous-pustular infection of the glans penis
5. Erosio interdigitalis blastomycetica Elgton Jenkins Jersey , an infection between the digits of the hands or toes
6. Folliculitis, with pustules developing most frequently in the area of the beard
7. Perianal candidiasis, a pruritic, erythematous, pustular infection surrounding the anus
8. Diaper rash, a common erythematous-pustular perineal infection in infants.People don't transfer money to Ireland as often as they used to. Why not? Because they are no longer as dependent on money being transferred into the country. With a strong Euro Darnell Savage Jr. Jersey , and weak Dollar, you can bet that people who transfer money to Ireland from the U.S are more concerned than ever about the sizable fees most offline money services charge.
Twenty years ago, Ireland was a relatively poor for a developed, Western European nation. Over the years, though, it has become what many call the "Celtic Tiger." Ireland has seen a boom in its economy over the past twenty years Rashan Gary Jersey , due in no small part to the tech industry.
How did Ireland achieve this status? In part perhaps of what made Ireland so good was that they had less government intervention than other EU countries. The nation was very inviting to large corporations from other countries in no small part because its corporate tax rate ranged between 10% and 12.5% during the late 1990s. And you can bet that foreign firms took full advantage of this; fully 93% of Ireland's exports are produced by Irish residents who are working for foreign corporations.
The country also made use of EU aid to bolster its education system, which many authorities cite is one reason that so much high-tech industry has come into the country over the last twenty years. Heavy-hitters like Intel, Dell, and even Microsoft all established operations in the country in the 1990s.
There were also many individuals from around Europe who, due mostly to family relations, bolstered the nation's economy when they sent remittance.
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