Intestinal Candidiasis Research Articles

The Candida Covid Connection: Preexisting Candida Overgrowth and Gut Dysbiosis Drives Long Covid

Long Covid has become a blight, its economic consequences overwhelming. But Long Covid (LC) may represent persistent Covid-19 in those with preexisting Candida overgrowth (CO). The features shared by both are striking. LC may be a growing subset of CO. The altered tryptophan metabolism encountered in LC is driven by IFN-γ in reaction to CO. Females are robust producers of IFN-γ, yet estrogen promotes CO. The consequent decline in serotonin and melatonin triggers the mood swings and sleeplessness respectively in LC. The low serotonin, the primary messenger in the gut brain axis, creates autonomic dysfunction. The CO induced gut dysbiosis and leaky gut initiate an autoimmune path. TNFα seen in both LC and this opportunistic yeast is at the center of the cytokine triad that leads to neurodegeneration. The Western diet, high in carbohydrates, alcohol, and glutamate, is exploited by this commensal turned parasite. Residual SARS CoV2 and Candida generate abundant ROS, inducing mitochondrial dysfunction. Alcohol tastes different for many with LC, because acetaldehyde requires functioning hepatic mitochondria. This article delves into the complex physiology and biochemistry that drive the symptoms of this conspicuous connection. Recent research has revealed innovative approaches that might address this global scourge, including D-mannose for the immune dysfunction and butyrate for the gut dysbiosis created by and seen in both LC and intestinal Candidiasis.

Th17-driven immunity to oral candidiasis is dependent on the microbiome and can be triggered by mono-colonization with segmented filamentous bacteria.

Abstract The opportunistic infection oropharyngeal candidiasis (OPC; oral thrush) is a common oral infection among the immunocompromised. The oral cavity is a major entry portal to the body and oral health impacts several aspects of host immunity. While much is now known about microbiome dependent Th17 induction and protection against intestinal candidiasis and other Th17 driven responses, our understanding of the role of the microbiome in oral Th17 induction and oral antifungal immunity is rather rudimentary. We demonstrate a direct role for the microbiome in triggering protection against OPC. While wildtype (WT) mice raised under specific pathogen free (SPF) conditions are resistant to OPC, WT germ free (GF) mice succumbed to infection. Reconstitution of WT-GF mice with segmented filamentous bacteria (SFB) was sufficient to restore protection against OPC with associated increase in Th17 cells, neutrophils, and antimicrobial responses in the oral mucosa. Thus, SFB mono-colonization in WT-GF mice triggers oral mucosal Th17 induction to protect against oral thrush and reveals a role of the microbiome in promoting oral mucosal immunity. Supported by R37-DE022550

Antifungal Activity of Natural Compounds vs. Candida spp.: A Mixture of Cinnamaldehyde and Eugenol Shows Promising In Vitro Results.

Candida spp. are commensal organisms of the skin, mucous membranes, gastrointestinal tract, blood, and vagina of animals and humans. In recent decades, the incidence of human fungal infections has increased, with Candida spp. (mainly C. albicans) infections being the most frequent, and the treatment of fungal infections is still a clinical challenge. Colonization of the human gastrointestinal tract by Candida spp. is significant because infections (e.g., candidemia and vulvovaginal candidiasis) frequently arise from commensal microorganisms. The aim of this study was to test in vitro the antifungal activity and the eventual synergistic effect of five pure components of essential oils: cinnamaldehyde, α-pinene, limonene, eucalyptol, and eugenol. These compounds were tested on 18 Candida strains (15 C. albicans, 2 C. glabrata, and 1 C. lusitaniae) derived from a culture collection of vaginal clinical strains. Methods: Fungistatic activity was evaluated using the disk diffusion method. For fungicidal activity, microdilution and time–kill curve protocols were set up. The checkerboard method was chosen to evaluate a possible synergistic effect of these compounds when mixed. Results: Cinnamaldehyde and eugenol gave the best results, inhibiting all the Candida strains and showing a highly additive effect (FICI 0.625). The cinnamaldehyde inhibition zone (IZ), MIC, and MFC means were 69 mm, 50.05 mg/L, and 109.26 mg/L respectively. Cinnamaldehyde led to the total loss of viable Candida cells within 4 h. Eugenol IZ, MIC, and MFC means were 35.2 mm, 455.42 mg/L, and 690.09 mg/L, respectively. Eugenol led to the total loss of viable fungal cells within 1 h. Treatment with α-pinene inhibited 88.9% of Candida strains, with an IZ mean of 21.2 mm, a MIC mean of 195.41 mg/L, and a MFC mean of 251.27 mg/L; this compound led to the total loss of viable fungal cells only after 24 h. Limonene inhibited only 33.3% of the tested strains and eucalyptol did not produce an inhibition halo, so these compounds were not tested further. Conclusions: These characteristics, together with the well-known safety of cinnamaldehyde and eugenol for human use, make these two natural compounds the perfect candidates for the treatment of candidiasis. This was a pilot study, the purpose of which was to evaluate the best composition of a mixture to be used against intestinal and vulvovaginal candidiasis; in vivo studies are needed to confirm these very encouraging results.

Construction and Antibacterial Study of Targeted Peptide Nanodrug Delivery System

The discovery of broad-spectrum antibiotics has greatly reduced human mortality due to bacterial infections, but the widespread use of broad-spectrum antibiotics in the past 20 years has led to the emergence of multiple drug resistance (MDR) pathogens, making bacterial infection modern serious problems facing medicine. In addition, the abuse of broad-spectrum antibiotics can also cause diseases such as intestinal flora imbalance, colitis, and candidiasis. Therefore, it is of great significance to develop new targeted antibacterial drugs, which can effectively treat bacterial infections while reducing the generation of drug-resistant bacteria and avoiding the imbalance of microbiota in patients. Based on this, we designed a temperature-responsive nano-drug delivery system containing antimicrobial peptides. The system uses gold nanostars as carriers to couple targeted antimicrobial peptides and loads them into thermosensitive hydrogels. It can form a gel according to the increase in the ambient temperature, and the photothermal effect is stable. In vitro antibacterial experiments show that the system has an excellent killing ability for StaphylococcuS.aureus. The method reported in this article hopes to provide a certain reference value for future nanoparticle antibacterial research.

Gastrointestinal Candidiasis in Malnourished Children with Diarrhoea

It is known that the frequency of intestinal Candidiasis in infants and children below 3 years of age is very high, particularly in malnourished children. It has been shown also that Candida can reduce the absorption of sugar, water and electrolytes (Burke et al., I977; Thelen et al., I978).
 Recently we have studied the frequency of gastrointestinal Candidiasis and the Candida-killing-ability of leucocytes in Indonesian children.
 Species of Candida were found significantly more often in throat swabs, gastric, small intestinal contents and stools of malnourished children in comparison with specimens of reasonably well-nourished children.
 Furthermore there were marked qualitative differences in the species found in these groups according to their nutritional status.
 Studying the Candidacidal activity of leucocytes it shows that in malnourished children the killing-ability is significantly lower than in well-nourished children. These findings suggest that gastrointestinal Candidiasis may contribute to the pathogenesis of diarrhoea in malnourished children.

Cecal perforation secondary to fungal necrotizing enterocolitis in a premature neonate.

IntroductionNecrotizing enterocolitis (NEC) remains one of the most critical gastrointestinal comorbidities associated with neonatal prematurity and low birth weight. Despite extensive research and innovations for successful management, NEC remains the leading cause of morbidity and mortality in premature infants. NEC is commonly appreciated at the level of the small bowel, but in rare instances, it is experienced at the colon. While colonic perforation is rare, cecal perforation, specifically, is seldom reported.Case reportWe report the successful surgical intervention of a preterm African-American infant born at 24-weeks' gestation found to have a cecal perforation due to fungal necrotizing enterocolitis.DiscussionPerforation is a major cause of morbidity in necrotizing enterocolitis, and even with extensive research in the management of necrotizing enterocolitis, mortality rates have remained unchanged; the treatment option with the most advantageous outcomes is still uncertain.ConclusionTo our knowledge, there are few reported cases of cecal perforation due to NEC. The pathologic report of our colonic specimen demonstrated mucosal invasion with Candida Albicans. This case report is noteworthy due to the unusual location of bowel perforation, fungal sepsis, and successful surgical outcome that is not commonly seen in neonates with intestinal candidiasis. Cecal perforation is rare in necrotizing enterocolitis but should not rule out the pathology.

Candida-Associated Gastric Ulcer Revisited

Candida-associated gastric ulcer occurs not only in debilitated but healthy individuals. Though had been reported to demonstrate nothing but nonspecific endoscopic features, it occasionally exhibits a typical finding I designated a candidarium. The natural history of the disease had not been clarified and the recurrence had not been described. However, I demonstrated that the ulcer not only occurs but also recurs in a different site with a different shape in a non-diabetic, H. pylori-negative patient, who has not taken NSAIDs, antibiotics, antineoplastic agents, or systemic corticosteroids, advocating that, contrary to the prevailing opinion, Candida is no innocuous bystander but an etiologic perpetrator. It has recently been shown to secrete a cytolytic PFT, candidalysin, into a pocket in the epithelium after penetrating into it to activate MAPK/MKP1/ c-Fos pathway, triggering release of damage as well as immune cytokines in OPC and VVC. While candidalysin, exerting an effect even on the adjacent oropharyngeal cells, directly injures the tissue with damage cytokines, immune counterparts activate PMNs to eventually terminate inflammation. Though the epithelial response to the fungus is different from organ to organ, it invades into and induces necrotic cellular damage to the IECs through the toxin to translocate: the action of candidalysin is proven not only on the squamous but on the columnar epithelium. Since, by analogy with intestinal candidiasis, it is never difficult to speculate that the PFT inflicts such damage to the gastric mucosa, a theoretically strong possibility has come up that Candida-associated gastric ulcer is actually Candida-induced.

Intestinal Parasitic Infection and Candidiasis among Pregnant Women Attending Antenatal Clinic in Ilie, Southwest Nigeria

Intestinal Parasitic Infection and Candidiasis among Pregnant Women Attending Antenatal Clinic in Ilie, Southwest Nigeria

Natamycin in the treatment of chronic recurrent vulvovaginal candidiasis associated with intestinal candidiasis

This article discusses the natamycin therapy outcomes in 50 patients with a combination of chronic recurrent vulvovaginal candidiasis (CRVC) and intestinal candidiasis dysbiosis (ICD) and analyses the features of the clinical manifestations of CRVC against the background of the ICD, the species composition and sensitivity patterns of Candida cultures isolated from women with vaginal and intestinal discharge to various antimycotics.

Prevalence and Factors Associated with Intestinal Candidiasis among HIV Infected Clients Attending Anti-retroviral Therapy Clinic at Kisoro District Hospital, Western Uganda

Prevalence and Factors Associated with Intestinal Candidiasis among HIV Infected Clients Attending Anti-retroviral Therapy Clinic at Kisoro District Hospital, Western Uganda

Značaj higijensko-dijetetskog režima u lečenju crevne kandidijaze

Candidiasis is a fungal infection caused by the fungus belonging to the genus Candida. It is normally present in the body, and in the event of a fall in immunity, it causes opportunistic infections. Symptoms of candidiasis vary depending on the part of the body that is affected. Intestinal candidiasis leads to a number of unpleasant symptoms: bloating, gasses, heartburn, cramps in the intestines, loss of appetite, abdominal flatulence, changes in the chair from fluid to hard, chronic tiredness, headache, depression. Risk factors that favor the development of intestinal candidiasis are stress, irregular nutrition and longterm use of some drugs (antibiotics, corticosteroids, immunosuppressants). After the examination, the diagnosis is confirmed by the candida finding in the chair. Treatment of intestinal candidiasis may take time because the infection has a tendency to return. The key to successful therapy is the change in diet (anticandida diet) and lifestyle and, eventually, the introduction of antifungal drugs. In the present case, the patient is diagnosed with intestinal candidiasis. Risk factors that have been exposed for a long time are: professional stress, improper diet, physical inactivity. The therapeutic approach is based on the hygienicdietary regime and changes in the lifestyle, education and cooperation of the patient. After three months there was a withdrawal of the symptoms, and the mycological examination of the chair was negative.

Intestinal candidiasis and antibiotic usage in children: case study of Nsukka, South Eastern Nigeria.

Overgrowth of candida results from factors that disrupt the intestinal microbial balance, such as the use of antibiotics. Unregulated antibiotic use and rampant practice of self-medication in Nigeria, is a cause for concern. A total of 314 stool specimens were collected from children <1 to 12 years of age in Nsukka, South Eastern Nigeria and screened for candida species using standard methods. Questionnaires were used to collect relevant information on the participants. Out of the 314 participants, 31.2% had candidiasis, indicated by growth of ≥105 CFU/ml. Four different species of candida were identified. Candida albicans had the highest prevalence (59.0%), while Candida krusei had the least prevalence (6.0%). Of the 314 participants, 46.5% had diarrhoea, out of which 58.9% had intestinal candidiasis while only 14.3% of the non-diarrhoeic children had candidiasis. Of 208 participants who had taken antibiotics within three weeks of the study, 42.3% had candidiasis compared to 20.8% of those with no recent history of antibiotic use. The results of this study showed a high prevalence of intestinal candidiasis among children in Nsukka. Strong associations were observed between the presence of intestinal candidiasis and diarrhoea, age and use of antibiotics (p<0.001).

Identification of pesticide and tobacco factors effects on intestinal biocenosis of the military personnel in Southern Kyrgyzstan.

Objective: To study the effects of environmental factors on intestinal biocenosis of the military personnel in Southern Kyrgyzstan. Materials and methods: To identify the effects of xenobiotic pollution on the state of intestinal biocenosis, a total of 183 soldiers were surveyed. Group I consisted of 98 recruits from the cotton and tobacco-growing areas, Group II 26 – recruits from urban areas, Group III – 59 recruits from unpolluted areas. Morning portions of the stool were collected and subjected to analysis. Identification of the isolated strains was carried out by conventional methods based on morphological, tinctorial and cultural properties of the microflora. Results: In Group I, 56 (57.1%) of the 98 recruits from the areas where pesticides are intensively used showed alterations of intestinal biocenosis: reduced number of bifidobacteria in 26 (26.5%), candidosis – in 15 (15.3%), reduced E.coli – in 8 (8.1%), enteropathogenic E. coli – 4 (4.08%), negative Staphylococci – 3 (3.06%). In Group II, of the total of 26 recruits from urban areas, 5 (19.2%) had intestinal dysbiosis, 3 (11.5%) showed an increased Candida, 1 (3.08%) – lack of bifidobacteria and 1 (3.08%) – reduced E. coli. In Group III, of the 59 recruits from unpolluted areas, 12 (20.3%) had dysbacteriosis, 7 (11.8%) had dysbacteriosis due to the decreased bifidobacteria, 3 (5.08%) had Proteus –Candida dysbacteriosis and 1 (1.7%) had intestinal candidiasis. Thus, dysbacteriosis is diagnosed less frequently (20.3%) among the recruits from unpolluted areas than among those from cotton- and tobacco-growing areas. Dysbacteriosis was reported in 19.2% of recruits from the urban areas. The major cause of dysbiosis is the reduction of bifidobacteria and E. coli, marked intestinal candidiasis. The impact of pesticides on the intestinal microflora is obvious, that is why it is necessary to carry out the correction of biocenosis of the intestines of the recruits from the areas with intensive pesticide use.

Gastrointestinal granuloma due to Candida albicans in an immunocompetent cat

A 3.5 year-old cat was admitted to the University of Melbourne Veterinary Teaching Hospital for chronic vomiting. Abdominal ultrasonography revealed a focal, circumferential thickening of the wall of the duodenum extending from the pylorus aborally for 3cm, and an enlarged gastric lymph node. Cytology of fine-needle aspirates of the intestinal mass and lymph node revealed an eosinophilic inflammatory infiltrate and numerous extracellular septate acute angle branching fungal-type hyphae. Occasional hyphae had globose terminal ends, as well as round to oval blastospores and germ tubes. Candida albicans was cultured from a surgical biopsy of the duodenal mass. No underlying host immunodeficiencies were identified. Passage of an abrasive intestinal foreign body was suspected to have caused intestinal mucosal damage resulting in focal intestinal candidiasis. The cat was treated with a short course of oral itraconazole and all clinical signs resolved.

İntestinal Kandidiyazisi Taklit Eden Duodenal Beyaz Benekler:Olgu Sunumu

Duodenal white spots are mentioned in these nonspecific lesions until recently. Although there is not enough studies about duedonal white spots yet; these lesions described in a separate syndrome. Here now we reported a case that we diagnosed multiple Duodenal white spots mimicking intestinal candidiasis. Clinical manifestation and endoscopic appearance of lesions gave rise to thought intestinal candidiasis histopathological examination revealed us several duodenitis. There was no evidence of fungal infection in PAS staining. Early after endoscopy patient took treatment of Lansoprozole at the 30 mg dose and bismuth salicylate. Patients compliant declined and control endoscopy exposed white duodenal spots cleared away three months later. Duodenal white spots are becoming to be designated as a separate disease even a syndrome. Etiology of duodenal white spots must be determined carefully during endoscopy. Sometimes it is difficult to make the correct diagnosis by appearance of lesion; in such cases histopathological examination can be useful both differential diagnosis of disease and determination of etiological factor.

Candida associated diarrhea in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients and their correlation with CD4+ T lymphocyte counts

Context: Gastrointestinal opportunistic infections occur very frequently in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients and diarrhea is one of the common clinical presentations among these patients. Candida spp. have also been implicated as a causative agent of chronic diarrhea in HIV-infected patients. Aims: This study was carried out to determine the prevalence of fungal pathogen among HIV/AIDS patients presented with diarrhea and their correlation with CD4+ T lymphocyte counts. Settings and Design: This cross-sectional study was conducted in the Department of Microbiology, RIMS, Imphal. Materials and Methods: A total of 158 stool samples were examined, out of which 108 were from HIV-positive patients with diarrhea (study group) and 50 from HIV-positive patients without diarrhea (control group). Specimens were examined by direct microscopy and culture in Sabouraud's dextrose agar. The CD4+ T lymphocyte count of patient was also recorded. Statistical Analysis Used: Data were analyzed by using Statistical Package for the Social Sciences (SPSS) version-16 software. P predictive value) value <0.05 was considered significant. Results: Confluent growth of Candida spp. was detected in stool samples of 28.7% patients with diarrhea and 12% patients without diarrhea. Association between the isolation of Candida spp. and diarrhea was found to be significant (P = 0.01). Isolation of Candida spp. was inversely correlated with CD4+ T lymphocyte count. Conclusion: Intestinal candidiasis must be held in mind as a cause of HIV/AIDS-associated diarrhea, particularly in patient with low CD4+ T lymphocyte count.

Rapid progression and unusual premortal diagnosis of mucormycosis in patients with hematologic malignancies: analysis of eight patients

Mucormycosis is a rare but emerging group of life-threatening opportunistic mycoses. We described experience of eight patients who developed mucormycosis. These patients had developed hematologic malignancies, and none achieved complete remission. Six of the eight patients presented with neutropenia, five received corticosteroid, and four had concomitant hyperglycemia. The most frequent physical finding was fever, and five patients complained of facial pain, headache, or chest pain. Four patients presented with concomitant bacterial infection, pulmonary aspergillosis, or intestinal candidiasis. Premortal diagnosis of mucormycosis was made in only one patient. Postmortem biopsy or autopsy was the diagnostic tool for the other patients. Although patients who were treated with amphotericin B survived longer than those treated with micafungin or voriconazole, all patients died due to the progression of mucormycosis. Estimated median survival was 23 days. Premortal diagnosis was rarely achieved as biopsy of infected tissues was the only diagnostic tool, and four patients who revealed dual infection were diagnosed with aspergillosis or bacterial infections. In patients with a high risk of mucormycosis presenting with pain and uncontrollable fever, mucormycosis should be included in the differential diagnosis. High dosages of liposomal amphotericin B should be given and surgical debridement should be performed promptly in cases highly suggestive of mucormycosis.

INTESTINAL CANDIDIASIS: An Uncommon Cause of Necrotizing Enterocolitis (NEC) in Neonates

Candida albicans produces intestinal perforation and necrotizing enterocolitis (NEC) in preterm newborns. We reviewed pathology files in neonates with a diagnosis of NEC (10-year period), gathered history, and reviewed histological materials. Of 249 autopsies, two (0.8%) had systemic candidiasis. From 66 surgical cases with a diagnosis of NEC, five cases (7.5%) had intestinal candidiasis. Candida albicans grew in pre- and post-mortem blood, lung, or peritoneal fluid in all cases. Histologically, the small bowel revealed fungi, sometimes intravascular. Systemic candidiasis with intestinal involvement is an important complication of prematurity and a prevalent cause of sepsis. The presence of intraluminal fungi with associated vascular occlusion may lead to bowel ischemia, necrosis, and perforation.

An evaluation of new treatment options for candidiasis using natural products

The aim of this paper is to evaluate new treatment options for candidiasis using natural products. It discussed clinical trials, which found that combination of two phytochemicals isolated from common food spices (anethole and polygodial) was able to suppress the growth of candida more rapidly and effectively than the conventional anti-fungal drugs, without any side effect. Candidiasis is the name given to common yeasts that live within human intestines and certain mucous membranes. We as humans are born with candida. They usually live in harmony with other intestinal fauna in our body when kept in check by acidophilus and other beneficial micro flora. In the absence of these checks, candida would grow rapidly and its overgrowth has been suggested as the origin of a complex medical syndrome called chronic Candidiasis also known as thrush. Family doctors either remain sceptical about intestinal Candidiasis or prescribe anti-fungal drugs with unpleasant side effects such as blurred vision, dry mouth and nausea. Scientists have found that these natural products could treat the condition without the side effects. In conclusion, the paper recommended that the natural treatment should be followed by drinking lots of water, eating diets low in carbohydrate but high in fibre and supplementing with acidophilus to stop recurrence of candidiasis. Keywords: candidiasis, natural products, Pimpella anisum, polygodial, Pseudowintera colorata Nigerian Journal of Natural Products and Medicine Vol. 9 2005: 11-13

Is Cronkhite???Canada Syndrome necessarily a late-onset disease?

Cronkhite-Canada Syndrome is a non-inherited, non-congenital disease characterized by juvenile hamartomatous gastrointestinal polyps with a typically late onset. In the case described herein the disease was diagnosed in a 17-year-old male with type I diabetes and thalassaemia minor, in coincidence with severe symptomatic intestinal candidiasis. Following the disappearance of the mycosis and correction of the protein and electrolyte imbalance, the ectodermal abnormalities returned to normal and the patient remained asymptomatic during a 7-year follow-up period, despite proteinuria resulting from membranous glomerulopathy. The concept that Cronkhite-Canada Syndrome is a late-onset disease should probably be reconsidered as it may remain asymptomatic, and thus not diagnosed, for a long a time.