Candidiasis (Thrush) Flashcards

1
Q

What causes vaginal candidiasis?

A
  • it is a vaginal infection with a yeast of the Candida family
  • the most common is Candida albicans
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2
Q

When does candida tend to cause symptoms?

A
  • it can colonise the vagina without causing symptoms
  • it progresses to infection when the optimum environment occurs
    • e.g. during pregnancy
    • or after treatment with broad spectrum abx that alter the vaginal flora
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3
Q

What are the risk factors for candida infection?

A
  • high oestrogen (e.g. during pregnancy)
  • poorly controlled diabetes
  • immunosuppression (+ use of corticosteroids)
  • broad-spectrum antibiotics
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4
Q

What are the symptoms of candidiasis?

A
  • thick, white discharge that does not smell
  • vulval / vaginal itching, irritation or discomfort
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5
Q

What can more severe candidiasis result in?

A
  • dyspareunia
  • erythema
  • fissures
  • excoriation
  • dysuria
  • oedema
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6
Q

When is treatment started for candidiasis?

A

usually treatment is started empirically based on presentation

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7
Q

What investigations may be performed?

A

vaginal pH:

  • in candidiasis, the pH will be < 4.5
  • in BV or trichomoniasis, the pH will be > 4.5

charcoal swab + microscopy:

  • confirms the diagnosis
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8
Q

What is the treatment for candidiasis?

A

treatment involves anti-fungal medications that can be delivered in several ways:

  • anti fungal cream (e.g. clotrimazole) inserted into the vagina with an applicator
  • anti fungal pessaries (e.g. clotrimazole)
  • oral anti fungal tablets (e.g. fluconazole)
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9
Q

What is the treatment recommendation if antifungal cream is being used?

A

a single dose of intravaginal clotrimazole cream at night

(5g of 10% cream)

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10
Q

What is the treatment recommendation if antifungal pessaries are being used?

A
  • a single dose of clotrimazole pessary (500mg) at night

OR

  • 3 doses of clotrimazole pessaries (200mg) over 3 nights
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11
Q

What is the treatment recommendation if oral antifungal medication is used?

A

a single dose of fluconazole 150mg

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12
Q

What is Canesten Duo?

A
  • an over the counter medication
  • it contains a single fluconazole tablet** and **clotrimazole cream to use externally for vulval symptoms
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13
Q

What advice needs to be given to women before prescribing antifungal creams or pessaries?

A
  • they can damage latex condoms and prevent spermicides from working
  • alternative contraception is required for at least 5 days after use
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