Review article                                                                                                UDC: 618.15-002.828

                                                                                                           doi:10.5633/amm.2014.0409

 

 

Vaginal candidiasis – gynecological aspect of the problem

Radomir Živadinović^1,2, Aleksandra Petrić^1,2, Dane Krtinić¹

 

 

Clinic of Gynecology and Obstetrics, Clinical Center Niš, Serbia¹

University of Niš, Faculty of Medicine, Serbia²

 

 

Vaginal candidiasis (VC) is one of the most common reasons for consultations with a gynecologist, with an increasing trend in occurrence in female patients. It is estimated that 75% of all women experience an episode of vulvovaginal candidiasis in their lifetime, 50% of them experience at least a second episode, and 5% have recurrent candidiasis. Cervical and vaginal secretions act as the last line of defense from ascendant infection pathway spreading. Factors that may disturb vaginal ecosystem are: endogenous factors, way of life, infectious factors and iatrogenic factors. The most common cause of VC in 85-90% of cases is C. albicans, but other Candida species  tend to be more likely to cause VVC (Candida tropicalis , Candida glabrata , C particulary, C crusei and so on). These non-albicans species have been found to be fluconazole and antimycotics resistant in more than 70% of cases. This is especially true for C. glabrata. There are several predisposing factors that have been associated with VC recurrence and resistance, such as Candida genotypes, resistance and virulence, immunodeficiency, unregulated hyperglycemia, use of oral contraceptives, long-term use of antibiotics. Therapy approach should be individual, including local and oral antimycotics until the symptoms disappear. The maintenance dose can be continuous or intermittent. Due to hormone concentration increase, increase in local glycogen, alternations of vaginal flora, VC incidence in pregnancy is two times higher in comparison to other female population. The problem of vaginal candidiasis requires individual approach, taking into account all the risk factors and accompanying physiological conditions or diseases in female patients. Acta Medica Medianae 2014;53(4):46-53.

 

Key words: vaginal candidiasis, vaginal discharge, recurrence, resistance, pregnancy