Candidiasis

Question 1

What is the definition of candidiasis?

Answer 1

Vaginal infection with a yeast of the candida family, commonly referred to as ‘thrush’.

Question 2

What is the most common organism to cause candidiasis?

Answer 2

Candida albicans

Question 3

What are some risk factors for candidiasis?

Answer 3

Increased oestrogen (eg pregnancy)
Poorly controlled diabetes
Immunosuppression
Broad spectrum antibiotics

Question 4

What is the pathophysiology of candidiasis?

Answer 4

Candida can colonise the vagina without causing symptoms but can progress to infection when the right environment occurs
Eg pregnancy, or treatment with broad spectrum antibiotics that alter vaginal flora

Question 5

What are some clinical features of candidiasis?

Answer 5

Thick white discharge that doesn’t smell
Vulval and vaginal itching, irritation or discomfort

Question 6

What are some investigations for candidiasis?

Answer 6

Usually treatment is started based on clinical diagnosis
If suspected resistant/complicated infection then swabs taken from anterior fornix or lateral vaginal wall and sent for microscopy, culture and sensitivity

Question 7

What is the management of candidiasis?

Answer 7

Antifungal cream inserted into vagina using an applicator (clotrimazole)
Antifungal pessary (clotrimazole)
Oral antifungal tablets (fluconazole)