Candidiasis

Question 1

what - candidiasis?

Answer 1

AKA thrush

Fungal infection caused by candida sp

Question 2

what are most candidiasis caused by?

Answer 2

80-90% of cases are causes by Candida Albicans

Question 3

What increases your risk of getting candidiasis?

Answer 3

-DM
-SGLT2i
-Recent antibiotic use
-Immunosuppression
-Increased oestrogen (higher in pregnancy, lower pre puberty and post menopause)

Question 4

presentation of candidiasis?

Answer 4

Vaginal discharge – thick, white, NOT smelly

Vulval and vaginal itching, irritation or discomfort

If more severe – erythema, fissures, oedema, pain during sex (dyspareunia), excoriation

Question 5

treatment for candidiasis?

Answer 5

Anti fungals:
* Fluconazole (oral antifungal tablet)
* Clotrimazole pessary (antifungal pessary)
* Clotrimazole Cream for external symptoms (antifungal cream- to be inserted into vagina with applicator)
+/- hydrocortisone
Genital skin care advice (soap substitutes)

Question 6

what should you warn the patient if they are using clotrimazole cream to treat their candidiasis?

Answer 6

Warn that the cream can break condoms and compromise spermacide!

Question 7

what investigations are done for candidiasis?

Answer 7

Often clinical
Could test vaginal pH using swab and pH paper to differentiate between BV, trichominas (both >4.5) and candidiasis (<4.5)

Question 8

what should be done if there’s suspected bacterial/ resistent or complicated infection?

Answer 8

Take swabs from the anterior fornix or lateral vaginal wall and send for microscopy, culture and sensitivity