Candidiasis

Candidiasis

Candidiasis is the most common fungal infection caused by candidia albicans and which accounts for the vast majority of fungal vulvo vaginal infections. Candida is a common inhabitant of the mouth, large intestine and vagina in 25-50% of healthy individuals. The particular environmental and biological factors that given rise to clinical infection by candida albicans are not understood, but some women may be more susceptible; predispostion to infection is associated with diabetes, pregnancy and the administration of antibiotics, particularly those like penicillin, that are effective against vaginal lactobacilli.

The rise of sexual transmission in candida infection is not clear; although the organism is often shared by sexual partners. Tight clothes and mid skill abrasions may contribute to clinical presentation of infection.

Presentation Sign and symptom

A woman may complain of vulval pruritus (itchiness) and an examination there may be evidence of vulvovaginitis and /or vulval, vaginal and anal erythema, dyspareunia is a common complaint. 

A vaginal discharge is common but not universal, and may be scant or thick and white with a curd like consistency and in same cases white thrush patches may be present on the vulva or walls of the vagina

Half of the babies born to infected women will be infected by candida, generally involving oral or gastro intestinal infection. Such infection is usually mild, but treatment of the mother prior to delivery is clearly desirable.

Diagnosis

·                 History of curd like vaginal discharge

·                 Itching, dyspareuina, etc.

·                 White thrush patches on vulva or wall of vagina Lab- Microscopy of vaginal smear (detection for spores or mycelia)

Treatment

·                 Vaginal infection is treated by the insertion of vaginal

·                 A number of antifungal treatments are available including:

·                 Clotrimazole pessaries - 100 mg for 6 nights or 200 mg for 3 nights

·                 with clotrimazole cream (1%) applied to uvlval two or three times daily

·                 Miconazole pessaries (supp) 150 mg for 3 nights

·                 Nystatin gel for external use 100,000 liu/g

Signs of clinical infection in a man, usually small red spots or plaques on the glans penis, should be treated with cream applied to the infected area.

Generally it is advised that sexual intercourse be avoided until after treatment is complete, perhaps to avoid local irritation which might provoke re-infection.