Candidiasis

Question 1

What is candidiasis?

Answer 1

Vaginal infection with yeast of the candida family

Question 2

What is the most common organism that causes thrush?

Answer 2

Candida albicans

Question 3

What are the risk factors for thrush?

Answer 3

Increased oestrogen - COCP
Poorly controlled diabetes
Immunosuppression
Broad-spectrum antibiotics
HIV

Question 4

What is the presentation of thrush?

Answer 4

Non-offensive ‘cottage cheese’ discharge
Vuval and vaginal itching
Dysuria
Superficial dyspareunia
Vulval erythema

Question 5

What is the first line investigation of thrush?

Answer 5

Usually clinically diagnosed
Vaginal pH
Charcoal swab - microscopy, culture

Question 6

What is the first line management of thrush?

Answer 6

Single oral 150mg fluconazole
Single 500mg clotrimazole vaginal pessary

External clotrimazole cream for vulval symptoms

Question 7

What is classed as recurrent thrush?

Answer 7

More than 4 episodes in one year

Question 8

What is the treatment of recurrent thrush?

Answer 8

Induction-maintenance regime
- Oral fluconazole every 3 days for 3 doses
- Oral fluconazole weekly for 6 months

Question 9

What is the first line of candidiasis in pregnanct women?

Answer 9

Clotrimazole pessary - oral fluconazole is contraindicated in pregnancy