vaginal candidiasis Flashcards
what is vaginal candidiasis ‘thrush’ caused by?
80% Candida albicans
20% other candida sp.
what factors may make vaginal candidiasis more likely to develop?
- DM
- drugs: abx, steroids
- pregnancy
- immunosuppression: HIV
what are the features of vaginal candidiasis?
- ‘cottage cheese’, non-offensive discharge
- vulvitis: superficial dyspareunia, dysuria
- itch
- vulval erythema, fissuring, satellite lesions
how do you investigate for vaginal candidiasis?
high vaginal swab not routinely indicated if clinical features are consistent with candidiasis
what are the mx options for vaginal candidiasis?
local or oral rx
local: clotrimazole pessary
oral: itraconazole, fluconazole
if pregnant: local only, oral C/I!
what is recurrent vaginal candidiasis?
4 or more episodes per year
in recurrent vaginal candidiasis, what should be checked?
compliance with previous rx
how do you confirm the dx of candidiasis in recurrent vaginal candidiasis?
- high vaginal swab for microscopy and culture
2. blood glucose test to exclude DM
what other differential dx should be considered for recurrent vaginal candidiasis?
lichen sclerosus
how do you treat recurrent vaginal candidiasis?
use of induction-maintenance regime
induction: oral fluconazole every 3 days for 3 doses
maintenance: oral fluconazole weekly for 6 months
