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Y4 Lecture Day I > Candidiasis > Flashcards

Candidiasis Flashcards

1
Q

What is candidiasis commonly known us? (2 names)

A
  • thrush
  • yeast infection
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2
Q

What’s the pathogen causing candidiasis?

A

Candida albicans

  • in 90% of cases
  • it is a commensal (part of normal flora of GI tract)
  • yeast-like fungus
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3
Q

Causes of candidiasis (2)

A
  • weakened immune system → opportunistic infection
  • hypersensitivity to the commensal organism (Candida Albicans) *genetics and oestrogen are thought to play a role
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4
Q

Risk factors of vulvovaginal candidiasis

A
  • Pregnancy
  • Diabetes
  • Use of broad spectrum antibiotics
    • ( normal vaginal micro-biota is altered)
  • Use of corticosteroids
    • immunosuppressive action → commensal candida grows excessively
  • Immunosuppression or compromised immune system
    • For example in HIV or cancer patients. May be associated with a more advanced and potentially life-threatening candida infection, or recurrent candidiasis which is difficult to treat.
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5
Q

What’s that?

A

A speculum examination showing white curd-like plaque on an anterior vaginal wall → candidiasis

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6
Q

Symptoms of vulvovaginal candidiasis

A
  • itchines → of the vulva, may extend to perianal region
  • visual discharge → white, curd-like and non-offensive
  • dysuria
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7
Q

Signs of vulvovaginal candidiasis

A
  • erythema and swelling of the vulva
  • satellite lesions (red, pustular lesions with pseudomembranous plaques that can be scrap off)
  • curd-like discharge in the vagina
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8
Q

What’s uncomplicated candidiasis?

A
  • a sporadic case of candiasis
  • mild-moderate symptoms
  • not associated with risk factors eg. diabetes, pregnancy, compromised immunity
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9
Q

Investigations of candidiasis in an uncomplicated case

A
  • speculum exam
  • measuring vaginal pH
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10
Q

Examples of complicated candidiasis

A
  • associated with risk factors -> pregnancy, diabetes, immunosupression
  • recurrent
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11
Q

Investigations in complicated candidiasis

A
  • vaginal smear → microscopic investigation of the sample

*presence of spores and mycelia /grzybnia/ → indicative of candida (however these may be also present in non symptomatic woman as candida albicans is a commensal)

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12
Q

Initial treatment of uncomplicated candidiasis

A
  • intravaginal anti-fungal → clotrimazole or fenticonazole

*usually inserted into vagina via applicator

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13
Q

What’s an alternative to the intra-vaginal treatment of candidiasis?

A
  • oral anti-fungal → fluconazole or itraconazole
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14
Q

Treatment of candidiasis. What can be prescribed with the conjunction of intra-vaginal or oral treatment?

A
  • Topical imidazole → this is to address vulval symptoms
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15
Q

What advice would you give with prescribing a topical Rx for candidiasis?

A

May weaken latex condoms

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16
Q

How many days would we expect the symptoms of candidiasis to settle down?

A

7-14 days

If it takes longer -> advise patient to return

17
Q

What (3) factors may contribute for Rx failure of candidiasis

A
  • alternative diagnosis -> take swabs for culture and microscopy, measure vaginal pH
  • patient’s risk factors e.g. diabetic with a poor control - improve control
  • non-concordance with medicaiton
18
Q

When to refer a patient with candidiasis?

A
  • if a treatment continues to fail
  • if non-albicans Candida species have been identified
19
Q

Advice given to a patient in order to prevent further candidal infections

A
  • use soap substitutes (not soup)
  • avoid cleaning the vaginal area more than once a day
  • avoid potential irritants e.g. shower gels, vaginal deodorants, douches
  • avoid wearing tight fitting underwear/tights
20
Q

Why candidiasis in pregnancy is more likely in some women?

A

Oestrogen levels are thought to have an impact on the likelihood of developing a candidiasis infection:

  • stimulate increased glycogen production → favourable environment for microorganisms to thrive
  • oestrogen may have a direct influence on the candida organism→ promoting its growth and encouraging it to ‘stick’ to the walls of the vagina
21
Q

Management of candidiasis in pregnancy

A
  • intravaginal antifungal (e.g. clotrimazole)

*! Do not give oral antifungals such as fluconazole and itraconazole!

  • Treat vulval symptoms with topical antifungal
  • Advise the patient to be careful to avoid physical damage when inserting intravaginal treatment applicator
  • When taking history note of any evidence of sexually transmitted diseases, as many STIs can affect the pregnancy. Refer to GUM (genito-urinary medicine) clinic if STI is suspected
  • Advise patient to return if symptoms have not resolved within 7-14 days
22
Q

Look at the pictures of candida

A

Y4 Lecture Day I (13 decks)

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