Candida vaginitis

Candidal vaginitis is a vaginal infection caused by Candida spp or, most commonly, C. albicans. Candidal vaginitis is most commonly caused by C. albicans, which is cultured in 15-20% of nonpregnant women and 20-40% of pregnant women. Risk factors for developing candidal vaginitis include diabetes, use of broad-spectrum antibiotics or glucocorticoids, pregnancy, constrictive underwear, immunodeficiency, and use of intrauterine contraceptives. Candidal vaginitis is rare in postmenopausal women, except in those receiving systemic hormone therapy.

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Symptoms of Candidal Vaginitis

Characteristic symptoms and manifestations are vaginal or boulevard itching, burning, irritation (which may intensify after sexual intercourse) and copious, cheesy discharge that adheres tightly to the vaginal walls. Symptoms and signs of the disease intensify a week before menstruation. Hyperemia, swelling and cracks in the mucous membrane of the vagina and vulva are common symptoms of the disease. Infected sexual partners may not show signs of the disease.

Diagnosis of candidal vaginitis

Diagnostic criteria for candidal vaginitis are: vaginal secretion pH less than 4.5; detection of yeast, pseudomycelium or mycelium when performing a KOH test.

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Treatment of candidal vaginitis

Vaginal or oral medications are highly effective. A single oral dose of 150 mg of fluconazole improves the condition. Topical pharmaceuticals butoconazole, clotrimazole, miconazole, and tioconazole are effective. However, patients should be warned that vaginal creams and ointments containing mineral or vegetable oil destroy latex-based condoms.

If symptoms persist or the disease progresses worsen with local therapy, it is necessary to exclude an allergic reaction to local antifungal drugs. Relapses of the disease are rare. Frequent relapses require the appointment of remote therapy with oral drugs: fluconazole 150 mg weekly for a month or ketoconazole 100 mg once a day.

Drugs for the treatment of candidal vaginitis

Type	Medicine	Dose
Preparations for local use	Butoconazole	2% cream 5 g once a day for 3 days, 2% cream 5 g for a single application
	Clotrimazole	1% cream 5g 1 time per day for 7-14 days. Vaginal tablets 100 mg 1 time per day for 7 days, or 200 mg 1 time per day for 3 days, or 500 mg once
	Miconazole	2% cream 5 g once a day for 7 days. Vaginal suppositories 100 mg once a day for 7 days or 200 mg once a day for 3 days.
	Nystatin	Vaginal tablets 100,000 IU 1 time per day for 14 days
	Terconazole	0.4% cream 5 g 1 time per day for 7 days or 0.8% cream 5 g 1 time per day for 3 days. Vaginal suppositories 80 mg 1 time per day for 3 days
	Tioconazole	6.5% ointment 5 g once
For internal use	Fluconazole	150 mg once