Vaginal Candidiasis

Question 1

what is the causative organism in vaginal candidiasis?

Answer 1

• 80% = candida albicans
• 20% other candida species

Question 2

what are risk factors for vaginal candidiasis?

Answer 2

• diabetes mellitus
• drugs
• pregnancy
• immunosuppression

Question 3

what drugs increase your risk of developing vaginal candidiasis?

Answer 3

• antibiotics
• steroids

Question 4

what are the features of vaginal candidiasis?

Answer 4

• ‘cottage cheese’ discharge
• non-offensive discharge
• vulvitis - superficial dyspareunia, dysuria
• itch
• vulval erythema, fissuring, satellite lesions

Question 5

what investigations are carried out in vaginal candidiasis?

Answer 5

typcially none
* high vaginal swab if features atypical
* diabetes screen

Question 6

what is the management of vaginal candidiasis?

Answer 6

1. oral fluconazole 150mg as single dose
2. clotrimazole 500mg intravaginal pessary

vulval symptoms = topical imidazole

Question 7

what is the definition of recurrent vaginal candidiasis?

Answer 7

4 or more episodes per year

Question 8

what investigations should be undertaken in suspected recurrent vaginal candidiasis?

Answer 8

• compliance with previous treatment
• high vaginal swab for microscopy and culture
• consider a blood glucose test to exclud diabetes

Question 9

what is the management of recurrent vaginal candidiasis?

Answer 9

induction-maintenance regime
* induction = oral fluconazole every 3 days for 3 doses
* maintenance = oral fluconazole weekly for 6 months