Vulva Candidiasis

Candidiasis

Yeast infection or moniliasis Pathophysiology: The majority of yeast infections are the result of Candida albicans although other types of Candida such as C. tropicalis, C. glabrata, and others can cause 25% of disease.

Factors that promote yeast infections include antibiotics, immunodeficiency, diabetes, chemotherapeutic agents, hormones, birth control pills and pregnancy, corticosteroids, HIV infections. Yeast infections are the most common vulvar infections but unfortunately up to 50% of women with yeast are misdiagnosed as most people assume that any symptom in the vulvovaginal area is due to yeast?

Clinically candidiasis can present as: i. The classic pattern of Candida infection - the acute onset of itch and burn with swelling of the labia, satellite pustules and a cottage cheese-like discharge with varying degree of fissuring and associated dysuria, and dyspareunia.

ii. Recurrent or chronic Candidiasis presents with recurrent itching and some degree of whitish discharge.

iii. There is an eczematous candidiasis that occurs in patients who are hypersensitive to Candida antigens. They are very itchy and they scratch their skin resulting in thickening referred to as lichenification. The skin of the vulva is red and swollen with scant to absent discharge and often recurrent fissuring.

iv. Cyclic vulvovaginitis can occur with episodes of itching, burning and irritation for a week or so around each menstrual cycle with or without symptoms of burning.

Diagnosis is with potassium hydroxide test and culture. Treatment involves controlling any contributing factors for example stopping antibiotics, controlling diabetes etc. Topical imidazole vaginal tablets can be used for 1-7 days. Systemic treatment is with oral fluconazole.