Vulvovaginal Candidiasis

Question 1

What is vulvovaginal candidiasis?

Answer 1

Vulvovaginal candidiasis, also known as thrush, is a fungal infection of the vulva and vagina caused primarily by Candida albicans.

Question 2

What are the common symptoms of vulvovaginal candidiasis?

Answer 2

Symptoms include vulvovaginal itching, soreness, thick white discharge, erythema, and dyspareunia (pain during intercourse).

Question 3

What is the appearance of discharge in vulvovaginal candidiasis?

Answer 3

The discharge is typically thick, white, and curd-like, often described as resembling cottage cheese.

Question 4

What causes vulvovaginal candidiasis?

Answer 4

It is caused by an overgrowth of Candida species, commonly due to factors like antibiotic use, diabetes, pregnancy, or immunosuppression.

Question 5

What are the risk factors for vulvovaginal candidiasis?

Answer 5

Risk factors include antibiotic use, pregnancy, poorly controlled diabetes, immunosuppression, and use of hormonal contraceptives.

Question 6

How is vulvovaginal candidiasis diagnosed?

Answer 6

Diagnosis is often clinical but can be confirmed by microscopy or culture of vaginal swabs.

Question 7

What is the pH of vaginal discharge in vulvovaginal candidiasis?

Answer 7

The vaginal pH typically remains normal (less than 4.5) in vulvovaginal candidiasis.

Question 8

How does vulvovaginal candidiasis differ from bacterial vaginosis?

Answer 8

Vulvovaginal candidiasis presents with thick white discharge and itching, while bacterial vaginosis has thin, grey-white discharge with a fishy odour and elevated pH.

Question 9

What are the differential diagnoses for vulvovaginal candidiasis?

Answer 9

Differentials include bacterial vaginosis, trichomoniasis, contact dermatitis, and sexually transmitted infections (e.g., chlamydia).

Question 10

What is recurrent vulvovaginal candidiasis?

Answer 10

Recurrent vulvovaginal candidiasis is defined as four or more episodes in a year.

Question 11

What is the first-line treatment for vulvovaginal candidiasis?

Answer 11

First-line treatment includes topical antifungals like clotrimazole or oral antifungals like fluconazole.

Question 12

What is the typical dose of fluconazole for vulvovaginal candidiasis?

Answer 12

A single oral dose of 150 mg fluconazole is commonly used for uncomplicated cases.

Question 13

What are the side effects of fluconazole?

Answer 13

Side effects may include nausea, headache, abdominal pain, and rare cases of liver dysfunction.

Question 14

How is vulvovaginal candidiasis managed in pregnancy?

Answer 14

Topical antifungals are preferred as oral antifungals like fluconazole are generally avoided in pregnancy.

Question 15

What lifestyle modifications can help prevent vulvovaginal candidiasis?

Answer 15

Avoiding tight clothing, maintaining good hygiene, and avoiding unnecessary antibiotic use can help prevent infections.

Question 16

How is recurrent vulvovaginal candidiasis treated?

Answer 16

Treatment involves a longer course of antifungal therapy, followed by maintenance therapy, such as weekly fluconazole for several months.

Question 17

What complications can arise from untreated vulvovaginal candidiasis?

Answer 17

Untreated cases may lead to chronic irritation, discomfort, and, rarely, ascending infections in immunocompromised individuals.

Question 18

Can vulvovaginal candidiasis affect men?

Answer 18

Men can develop candidal balanitis (inflammation of the glans penis) if exposed to an infected partner, though it is less common.

Question 19

How can vulvovaginal candidiasis be differentiated from trichomoniasis?

Answer 19

Trichomoniasis typically presents with frothy, yellow-green discharge and a raised vaginal pH, unlike the thick white discharge in candidiasis.

Question 20

What is the role of probiotics in vulvovaginal candidiasis?

Answer 20

Probiotics may help maintain vaginal flora balance, but evidence for their effectiveness in treating candidiasis is limited.

Question 21

What is Candida glabrata, and how does it affect treatment?

Answer 21

Candida glabrata is a less common cause of candidiasis and may be resistant to standard antifungal treatments like fluconazole.

Question 22

What is the significance of vulvovaginal candidiasis in immunocompromised patients?

Answer 22

Immunocompromised patients are at higher risk of recurrent and severe infections, which may require systemic antifungal therapy.

Question 23

Is vulvovaginal candidiasis sexually transmitted?

Answer 23

No, vulvovaginal candidiasis is not considered a sexually transmitted infection, although sexual activity may trigger symptoms.

Question 24

When should a patient with vulvovaginal candidiasis be referred to a specialist?

Answer 24

Referral is indicated for recurrent infections, treatment-resistant cases, or when symptoms suggest an alternative diagnosis.