Candida Vaginitis
While vulvovaginal candidiasis is a common form of vaginitis in females, it is often a problem determining true infection from nonpathogenic colonization. Candida albicans causes about 85% of infections. The infection can also be sexually associated as sexual intercourse or contact is not necessary for an infection. Predisposing factors include diabetes mellitus, pregnancy, oral contraceptives, oral steroid use, broad-spectrum antibiotics and immunocompromising diseases. In addition, some women probably have a mild Candida antigen-specific immunologic deficiency.
Candida vaginitis is associated with intense burning, pruritus and erythema. The discharge is often similar to that above which is a thick, curdy, cottage-cheese appearance. On wet mount or KOH smear, one can visualize budding yeast and pseudohyphae as seen below. The KOH prep has a sensitivity of about 40% to 80%. Rapid diagnostic tests are becoming available but have not been well studied. Culture is expensive and time consuming.
Treatment can be done either through one of the many topical agents or oral therapy as outlined in CDC guidelines. It is important to remember that:
Single dose interventions should be reserved only for mild/moderate cases
In recurrent severe infections, oral agents may need to be used for a more extended period of time.
Follow-up is only needed if symptoms persist.
Treatment of partners does not effect the course.
The topical agents are ok to use in pregnancy.
http://www.usc.edu/student-affairs/Health_Center/adolhealth/content/b3stis3.html
Αποστολέας