Vaginal candidiasis

Vaginal candidiasis is one of the most common vaginal diseases of infectious etiology and its incidence has increased in recent years. In the United States, 13 million cases of the disease are reported each year, representing 10% of the female population. 3 out of 4 women of reproductive age have had vaginal candidiasis at least once. Some are treated with this drug:

What causes / Causes of vaginal candidiasis:
The causative agent is yeast-like fungi of the genus Candida. The vagina is most often (95%) affected by Candida albicans fungi, less often by C. glabrata, C. tropicalis, C. krusei, etc. Candida fungi are unicellular aerobic microorganisms, ranging in size from 1.5 to 10 microns in round shape. The temperature of 21-37 °C and a slightly acidic environment are optimal for the growth and reproduction of fungi.

Genital candidiasis is not a sexually transmitted disease, but it is often a marker of it. Fungi belong to conditionally pathogenic flora that normally live on the surface of skin and mucous membranes, including the vagina. However, under certain conditions (decrease of general and local resistance, taking antibiotics, oral contraceptives, cytostatics and glucocorticosteroids, diabetes, tuberculosis, malignant tumors, chronic infections, etc.) it can cause a disease. In this case, the adhesive properties of fungi are increased, which attach to the cells of the vaginal epithelium, causing colonization of the mucous membrane and the development of an inflammatory reaction. Usually candidiasis affects only the superficial layers of the vaginal epithelium. In rare cases, the epithelial barrier is overcome and invasion of the pathogen into the underlying tissues with hematogenous dissemination occurs.

There is evidence that in recurrent urogenital candidiasis the main reservoir of infection is the intestine, from where fungi periodically enter the vagina, causing an exacerbation of the inflammatory process.

Infection of newborns with Candida fungi most often occurs intrapartum.

Classification. A distinction is made between acute (duration of the disease up to 2 months) and chronic (recurrent, duration of the disease more than 2 months) urogenital candidiasis.

Symptoms of vaginal candidiasis:
Vaginal candidiasis causes complaints of itching, burning in the vagina, and a curd-like discharge from the genital tract. Itching and burning increases after water procedures, intercourse, or while sleeping. Involvement of the urinary tract leads to dysuric disorders.

Diagnosis of vaginal candidiasis:
Diagnosis of vaginal candidiasis is based on complaints, history (conditions for candidiasis), and gynecologic examination findings. In the acute period of the disease, the skin of the external genitalia is secondary involved in the inflammatory process. Vesicles form on the skin, they open and leave erosions. Examination of the vagina and the vaginal portion of the cervix using mirrors reveals hyperemia, edema, white or gray-white curd-like deposits on the vaginal walls. Colposcopic signs of vaginal candidiasis after Ljugol staining include small dots in the form of “semolina” with a pronounced vascular pattern. In chronic candidiasis secondary elements of inflammation prevail – tissue infiltration, sclerotic and atrophic changes.

Microbiological examination is the most diagnostically informative. Microscopy of a native or Gram stained vaginal smear can detect spores and pseudomycelium of the fungus. A good adjunct to microscopy is the cultural method – culture of the vaginal contents on artificial nutrient media (Sabouraud’s medium, 5% blood agar). Cultural examination determines the species belonging of fungi, as well as their sensitivity to antimycotic drugs.

Additional methods for vaginal candidiasis include examination of the intestinal microbiocenosis, examination for sexually transmitted infections, and analysis of the glycemic profile with load.