CANDIDIASIS Candida albicans Dr Hani Masaadeh MD PhD

1. CANDIDIASIS Candida albicans Dr Hani Masaadeh MD PhD

2. Candida albicans is a dimorphic fungus that grows at 37oC. Its normal habitat is the mucosal membranes of humans and other warm-blooded animals. The same strains of C. albicans that grow as harmless commensals can become pathogenic, invading the mucosa and causing significant damage.

10. Host Factors Impaired glucose tolerance Diabetes mellitus Broad spectrum antibiotics Contraceptive pills Pregnancy Use of spermicidal jelly Steroid therapy Immunodeficiency Mechanical irritation

11. Yeast Factors Virulence : ability to adhere to vaginal epithelium�� Protease production : Increased invasiveness� Germ tube formation : increase adherence

12. C. albicans causes vaginitis - inflammation and invasion of the vaginal mucosa, especially during the third trimester of pregnancy and in women who take the pill. Serious invasive infections with Candida species are usually acquired by sexual contact The following predisposes a person to systemic infection by Candida albicans : A) severe burnsB) broad spectrum antibioticsC) post-operative statusD) corticosteroids

13. Symptoms ������� Vaginal itch and/or soreness ������� Thick cheese like discharge ������� "Burning" discomfort around the vaginal opening, especially if urine contacts the area ������� Pain or discomfort during sexual intercourse.

14. Vulvovaginitis in the female is the commonest syndrome producing itching and a white curdy discharge. In men, tiny pustules occur on the glans or a white sodden appearance in the preputial fold.

20. Diagnosis . Typical appearance of discharge. To be differentiated from other vaginal infections- bacterial vaginosis and trichomoniasis. The pH is acid/ normal; lactobacilli still present and wet preparation or gram stain will show the typical hyphae or spores

21. Treatment Vaginal yeast infections can be treated with antifungal medicines that are inserted directly into the vagina as tablets, creams, ointments or suppositories. These medications include butoconazole (FemStat), clotrimazole (Clotrimaderm, Canesten), miconazole (Monistat, Monazole, Micozole), nystatin (several brand names), tioconazole (GyneCure) and terconazole (Terazole).

22. Recommended Drug Regime for Recurrrent Vaginal Candidiasis Treatment for Acute Episode Clotrimazole, Fluconazole, Ketoconazole, Terconazolecream Maintenance Clotrimazole,Ketoconazole, Fluconazole, Itraconazole

23. Skin Conditions Misdiagnosed as Recurrent Vaginal Candidiasis Irritant contact dermatitis Vulvar vestibulitis Bacterial vaginosis Genital herpes Physiological discharge Tinea cruris Psoriasis

24. Diagnosis The doctor will suspect an infection based on the symptoms. The pelvic exam will typically show inflammation and a white discharge in the vagina and around the vaginal opening. The doctor may also take a sample of the vaginal discharge for laboratory examination under a microscope or for a "yeast" test to see if Candida fungi grow in the laboratory.

25. Expected Duration Proper treatment cures up to 90 percent of vaginal yeast infections within two weeks or less (often within a few days). A small number of people will have repeat infections.

27. When To Call A Professional Call your doctor whenever you have vaginal discomfort or an abnormal vaginal discharge, especially if you are pregnant.

28. Prognosis Medications cure most vaginal yeast infections. About 5 percent of women develop RVVC and may require further treatment with antifungal therapy.

29. Prevention To help prevent vaginal yeast infections, you can try the following suggestions: ������� Keep the external genital area clean and dry. ������� Avoid irritating soaps (including bubble bath), vaginal sprays and douches. ������� Change tampons and sanitary napkins frequently. ������� Wear loose cotton (rather than nylon) underwear that doesn't trap moisture. ������� Take antibiotics only when prescribed by your doctor, and never take them for longer than your doctor directs.