Esophageal candidiasis pathophysiology: Difference between revisions

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{{Oral candidiasis}}
{{CMG}};{{AE}}{{AY}}
==Overview==
[[Candida]] is a normal [[commensal]] of the skin and mucous membranes. The balance between the [[virulence]] of the [[fungus]] and the [[Immune response|host immune defense]] is responsible avoiding [[opportunistic infection]] of candida.
Deficiency of [[cell-mediated immunity]] or poor general status are the main risk factors for having opportunistic candidiasis.
Candidiasis is usually localized to skin and mucous membranes. In rare cases, candidiasis can spread causing [[Candidiasis|candidemia]] and distant infection. These cases are usually associated with [[Immunodeficiency|deficient immunity]]
. [[C. albicans]] is the main species causing infection in humans more than any other [[Candida|candida species]].


==Pathophysiology==
===Pathogenesis===
Candida is a [[Commensal|normal commensal]] of skin and mucous membranes. A [[Immune system|competent immune system]] and an intact regenerating healthy skin prevent the [[virulence]] of [[Candida]].
====Candida Virulence factors====
The main [[virulence factors]] that mediate the infection:<ref name="pmid23302789">{{cite journal |vauthors=Mayer FL, Wilson D, Hube B |title=Candida albicans pathogenicity mechanisms |journal=Virulence |volume=4 |issue=2 |pages=119–28 |year=2013 |pmid=23302789 |pmc=3654610 |doi=10.4161/viru.22913 |url=}}</ref>
*Secreting '''molecules that mediate adherence''' into host cells
*Production of '''[[hydrolases]]''' which has a [[Lytic|lytic effect]] on tissues and facilitate the invasion by the [[fungus]].
*'''[[Polymorphism]]:''' [[Candida]] has the ability to grow either as [[Hyphae|pseudohyphae]] (elongated ellipsoid form) or in a [[Yeast|yeast form]] (rounded to oval budding form. While the role of [[polymorphism]] is not clearly understood in the [[virulence]] of [[Candida]], it’s noted that the species that are capable of producing the most severe form of the disease has this ability.
*'''[[Biofilm|Biofilm production]]:''' which means the ability to form a thick layer of the [[organism]] on the [[Mucosal|mucosal surfaces]] or even on [[catheters]] and [[dentures]].
Any condition that compromises [[cell-mediated immunity]], worsens the general status of the patient or provide a favorable medium for [[Candida]] to form [[biofilms]] put the patient at increased risk for having candidiasis.<ref name="pmid16984866">{{cite journal |vauthors=Pappas PG |title=Invasive candidiasis |journal=Infect. Dis. Clin. North Am. |volume=20 |issue=3 |pages=485–506 |year=2006 |pmid=16984866 |doi=10.1016/j.idc.2006.07.004 |url=}}</ref>
[[Gene|Candidal gene]] [[VPS4A|VPS4]] plays an important role in mucosal candidiasis specifically. Moreover, fungi with mutations affecting this [[gene]] were found to be less virulent.<ref name="pmid25483774">{{cite journal |vauthors=Rane HS, Hardison S, Botelho C, Bernardo SM, Wormley F, Lee SA |title=Candida albicans VPS4 contributes differentially to epithelial and mucosal pathogenesis |journal=Virulence |volume=5 |issue=8 |pages=810–8 |year=2014 |pmid=25483774 |doi=10.4161/21505594.2014.956648 |url=}}</ref><ref name="pmid18814053">{{cite journal |vauthors=Lee SA, Jones J, Hardison S, Kot J, Khalique Z, Bernardo SM, Lazzell A, Monteagudo C, Lopez-Ribot J |title=Candida albicans VPS4 is required for secretion of aspartyl proteases and in vivo virulence |journal=Mycopathologia |volume=167 |issue=2 |pages=55–63 |year=2009 |pmid=18814053 |doi=10.1007/s11046-008-9155-7 |url=}}</ref>
===Gross Pathology===
===Microscopic pathology:===
{| style="float: right; width: 350px;"
| [[Image:Calbicans.jpg|right|400px|thumb|Candida albicans - By Y tambe - Y tambe's file, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=233284]]
|}
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*Microscopic examination of the wet mount with 10% KOH or saline demonstrates [[hyphae]], pseudohyphae, and [[Yeast|blastospores]].
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==References==
{{Reflist|2}}
[[Category:Needs content]]
[[Category:Disease]]
[[Category:Fungal diseases]]
[[Category:Gastroenterology]]
[[Category:Infectious disease]]
[[Category:Primary care]]
{{WH}}
{{WS}}

Revision as of 20:26, 28 May 2017