Vaginal Thrush Flashcards
1
Q
What organism causes vaginal thrush?
A
- Candida Albicans - 90%
2
Q
If candida is a normal commensal organism in the vagina, what causes symptomatic vaginal thrush?
A
- hypersensitivity response to the commensal organism due to
- genetically
- oestrogen
3
Q
Which age group is commonly affected by VT?
A
- 20-40 years
4
Q
What are the RF for VT?
A
- Pregnancy
- Diabetes mellitus
- Treatment with broad-spectrum antibiotics
- Chemotherapy
- Vaginal foreign body
- Contraceptives may predispose to recurrent vaginal and vulval candidiasis
5
Q
What are the Sx for VT?
A
- Pruritus vulvae
- Vulval soreness
- White, ‘cheesy’ discharge
- Non-offensive
- Dyspareunia (superficial).
- Dysuria (external)
6
Q
What are the signs of of VT?
A
- Vulval erythema, possibly with fissuring.
- Vulval oedema.
- Satellite lesions.
- Excoriation
7
Q
What are the differntials for VT?
A
- Bacterial vaginosis
- Trichomonas vaginalis.
- STIs
- Helminthic infection (particularly threadworm/pinworm in young girls).
- Contact dermatitis (enquire about new hygiene products).
- Mechanical irritation - eg, long-distance cyclists, sexual abuse in girls.
- Urinary tract infection.
8
Q
What Ix would you perform for VT?
A
- Self taken swabs
- MSU if UTI suspected
- Vaginal swab from anterior fornix or lat vaginal wall for MCS if suspect complicated infection
9
Q
How would you mx VT?
A
Conservative
- use soap substitute to clean vulval area
- use emollient to moisturise vulval skin
- maintain good hygiene
Pharmacological
- intravaginal antifungal - clotrimazole 500mg pessary single dose
- oral antifungal - fluconazole 150mg orally single dose
- topical imidazole
- If pregnant - use clotrimazole 100mg pessary for 6 nights
*topical treatment may worsen burning symptoms in the first few days
10
Q
What patient group are prone to getting recurrent VT?
A
- Diabetes mellitus.
- Immunosuppression.
- Broad-spectrum antibiotic use.
- A possible link with allergy, particularly allergic rhinitis
11
Q
A
