What Is Candidal Vulvovaginitis?

Candidal vaginitis, also called fungal vaginitis, is caused by a Candida infection. Its incidence is second only to bacterial vaginosis. Candida vaginitis is more common in young girls, pregnant women, diabetic patients, and patients who have been treated with higher doses of estrogen after menopause.

Basic Information

nickname

Fungal vaginitis

English name

monilial vaginitis

Visiting department

Gynecology

Multiple groups

Young girls, pregnant women, diabetics

Common locations

vaginal

Common causes

Candida infection

Common symptoms

Leucorrhea, burning and itching of the vulva and vagina, dysuria due to external causes, erythema on the vulva

Causes of candidal vaginitis

Its main cause is imbalance of vaginal flora. It can also be seen in sexual contact, contaminated clothing, sanitary napkins, sanitary paper, and pads that have failed disinfection.

There are many kinds of molds, and the main one in the human body is Candida albicans. 80% to 90% of fungal vaginal infections are caused by Candida albicans, and the rest are other Candida and Coctococcus spp. Therefore, fungal vaginitis is actually Candida vaginitis or vaginal candidiasis. Candida albicans is oval in shape, and sprouts and cells sprout to form pseudohyphae. The pseudohyphae and the spores are connected into branches or chains. Candida is usually a spoilage parasite that can live in the skin, mucous membranes, digestive tract, or other organs of the normal human body, is present in the vagina, and is often asymptomatic. When the vaginal glycogen increases, the acidity increases, or the body's resistance decreases, it can become the cause of the disease. Long-term application of broad-spectrum antibiotics and adrenal corticosteroids can greatly increase mold infections. Because the two drugs mentioned above can cause imbalance of the flora in the body, change the mutual restriction relationship between the microorganisms in the vagina, and reduce the ability to resist infection. In addition, vitamin deficiency (complex vitamin B), severe infectious diseases, and other depleting diseases can all be favorable conditions for Candida albicans reproduction. Increased glycogen content in vaginal epithelial cells during pregnancy, increased vaginal acidity, and decreased renal glycemic threshold in pregnant women, often with gestational diabetes, increased sugar content in urine and promoted the growth and reproduction of Candida albicans.

Clinical manifestations of candidal vaginitis

The most common symptoms of a Candida infection are multiple vaginal discharge, burning and itching of the vulva and vagina, difficulty with urination due to external causes, and erythema on the vulva. The typical vaginal discharge is curd-like or bean-dreg-like, and the vaginal mucosa is highly red and swollen. White thrush-like plaques are attached and easy to peel off. Below it is the erosive base of the damaged mucosa, or a superficial ulcer is formed. In severe cases, bruising may remain. But leucorrhea does not all have the above-mentioned typical characteristics. It can appear from water samples to curd-like leucorrhea, if any, they are all thin and clear serous exudates, which often contain white flakes. The pruritus symptoms of mycotic vaginitis during pregnancy are particularly serious, and even restlessness and pain can cause frequent urination, dysuria, and pain during intercourse. In addition, about 10% of women and 30% of pregnant women are carriers of mold, but they have no clinical manifestations.

Candidal vaginitis check

For severe and refractory vulvar pruritus, the first consideration should be whether or not a fungal infection can be diagnosed by direct smear examination and culture of the local secretions. The mycelial branches and spores of the fungus can be easily seen under the microscope. Candida albicans is oval and negative for Gram staining, but the staining is usually uneven, about 3 to 5 m (several times larger than staphylococcus), and often produces long shoots without shedding (spores), so that it looks like a hypha It is not hyphae, so it is called pseudohyphae.

Candidal vaginitis diagnosis

Based on typical clinical manifestations and visual inspection of vaginal excreta, the diagnosis of fungal vaginitis is usually not difficult. However, for atypical cases, in order to confirm the diagnosis, those who are suspected of carrying mold or understand the effect of treatment must perform a vaginal discharge examination, and the reliability can be increased to 80%. The most reliable method is to carry out mold culture. In addition, we must also pay attention to the relevant incentives, such as the use of high-dose steroid hormones or a history of broad-spectrum antibiotics, and diabetes patients need to do urine glucose and blood glucose tests.

Candidal vaginitis treatment

1. Change the pH of the vagina

If the vagina is flushed with alkaline drugs, the vagina can be flushed with 2% to 4% soda fluid to change the living environment of mold. But its effect is still controversial.

2. Drug treatment

(1) Nystatin vaginal suppository, which is inserted deep into the vagina, once each morning and evening or once every night for a total of 2 weeks. Clotrimazole or miconazole suppositories can also be used.

(2) Oral nystatin or fluconazole.

(3) Apply topical rubbing such as compound nystatin cold cream or miconazole cream twice daily.

Pregnant women suffer from fungal vaginitis. Although there is a possibility of self-healing after childbirth, the newborn is at risk of being infected. Therefore, it is still necessary to treat it promptly, and topical medication is appropriate.

3. Male carriers

For male carriers, routine treatment is also required, which is one of the important measures to prevent female patients from recurring.