Today is our topic of discussion Vaginal candidiasis
Vaginal candidiasis
Definition:
Vaginal candidiasis is an infection of the vagina, due to the fungus Candida albicans.
Pathology:
Candida and other microorganisms live in the vagina keeping each other in balance When the vagina has certain favorable conditions, the number of Candida increases, leading to the clinical manifestation.
Though it is not a STD, few men may develop symptoms such as itching and a rash on the penis after having intercourse with an infected partner.
Aetiological factors:
1. Antibiotics (used to treat other infection)
2. Pregnancy
3. Diabetes
4. Obesity
5. OCP use
Symptoms:
1. The condition may not cause any symptom
2. Abnormal vaginal discharge
3. Dyspareunia (Pain with intercourse)
4. Vaginal and labial itching, burning
Signs:
1. Discharge is thick, white and curdlike which tends to form dry, white plaques on the vaginal wall. Sometimes it may range from watery to purulent.
2. Pelvic examination will reveal swelling and redness of the skin of the vulva, vagina, and on the cervix.
3. Vagina may be tender and removal of white plaques yields haemorrhagic spots.
Investigation:
Examination of vaginal discharge with potassium hydroxide (KOH) under microscope (called ‘wet mount’ test).
Treatment:
A. For vaginal candidiasis:
Miconazole or clotrimazole, 200 mg intravaginally, daily for 3 days
Or
Clotrimazole, 500 mg intravaginally, as a single dose
Or
Fluconazole, 150 mg orally, as a single dose (avoided in first trimester of pregnancy)
B. Elimination of aetiological factors (e.g., diabetes mellitus and discontinuing OCP)
C. Husband should be treated with nystatin ointment following coitus.
Preventive measure:
1. Keep the genital area clean and dry by maintaining personal hygiene.
2. Avoid vaginal douching and sprays, fragrances, or powders in the genital area.
3. Husband should use barrier method of contraception until cured.
4. Wearing loose clothes. Avoid underwear made of silk or nylon, because these materials are not very
absorbant and restrict air flow. This can increase sweating in the genital area, which can cause irritation.
5. Controlling blood sugar levels in diabetics.
Complications:
1. Chronic or recurrent infections may occur without proper treatment.
2. Secondary infection may occur due to intense or prolonged scratching which makes the skin of the vulva to become cracked and raw, making it likely to get infected.
Conjunctivitis
Definition:
Inflammation of the conjunctiva is called conjunctivitis.
Classification:
Bacterial
a. Staphylococcus aureus
b. Niesseria gonorrhoea
C. Pneumococcus
d. Chlamydia trachomatis (‘trachoma’)
Viral:
Adenovirus & Herpes simplex virus
Fungal:
Rhinosporidium
Allergic:
a. Simple allergic conjunctivitis
b. Phlyctenular conjunctivitis
Chemical, toxin and drugs:
Dust, fume, acid, alkali etc.
Traumatic 7. Systemic disease:
Thyrotoxicosis
Autoimmune disease:
Reiter’s disease
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