Candida vulvovaginitis: A store with a buttery and a show window.
Gilbert G G DondersJack D SobelPublished in: Mycoses (2016)
Although being an utterly frequent, non-mortal, yet distressing disease, and despite good knowledge of the pathogenesis and the availability of specific and safe treatment, vulvovaginal Candida (VVC) infection remains one of the most enigmatic problems for both physicians and patients. Good treatment requires a proper diagnosis. Too many caregivers (and patients treating themselves) react too simple-minded on the symptoms of VVC and treat VVC where they see it on the vulva. In this opinion paper, we plea for a thorough examination of women with VVC, especially in those women who suffer from recurrent disease since a long time, sometimes decades, which necessitates intensive examination of the vaginal flora, as this is invariably the reservoir for relapses and recurrent vulvitis. Examination of such complicated cases requires experienced clinical judgement, expertise bedside phase contrast microscopy of fresh vaginal fluid, classical cultures on Sabouroud medium and, if still unresolved, repetitive cultures taken by the patient herself at moments of symptoms, and/or nuclear acid amplification techniques to detect Candida genes in the vaginal fluid. Even if only vulvitis is evident, thorough expert examination of vaginal fluid is obligatory to diagnose VVC.
Keyphrases
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- primary care
- candida albicans
- healthcare
- magnetic resonance
- peritoneal dialysis
- biofilm formation
- type diabetes
- gene expression
- high frequency
- palliative care
- mental health
- adipose tissue
- computed tomography
- magnetic resonance imaging
- staphylococcus aureus
- pseudomonas aeruginosa
- case report
- mass spectrometry
- optical coherence tomography
- depressive symptoms
- high resolution
- clinical practice
- high throughput
- genome wide
- sleep quality
- pregnancy outcomes
- combination therapy
- polycystic ovary syndrome