Candida vulvovaginitis

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A. Incidence. Candida vulvovaginitis accounts for one-third of vaginitis. Up to 75% of women report having had at least one episode of candidiasis. The condition is rare before menarche. It is less common in postmenopausal women, unless they are taking estrogen replacement therapy.

B. Microbiology and risk factors. Candida albicans is responsible for 80-92% of vulvovaginal candidiasis. Sporadic attacks of vulvovaginal candidiasis usually occur without an identifiable precipitating factor.

1. Antibiotics. A minority of women are prone to vulvovaginal candidiasis while taking antibiotics.

2. Intrauterine devices have been associated with vulvovaginal candidiasis.

3. Pregnancy. Symptomatic infection is more common in pregnancy.

C. Clinical features. Vulvar pruritus is the dominant feature. Women may also complain of dysuria (external rather than urethral), soreness, irritation, and dyspareunia. There is often little or no discharge; that which is present is typically white and clumpy. Physical examination often reveals erythema of the vulva and vaginal mucosa. The discharge is thick, adherent, and "cottage cheese-like."

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