vulvovaginal candidiasis

Vulvovaginal Candidiasis (VVC) Description

Vulvovaginal candidiasis, commonly referred to as a vaginal yeast infection or thrush, is a fungal infection that affects the vagina and vulva. It is caused by an overgrowth of the fungus Candida, typically Candida albicans.

Symptoms

The symptoms of VVC can range from mild to severe and may include:

• Itching, soreness, and burning discomfort in the vagina and vulva
• Stinging when passing urine (dysuria)
• Vulval oedema, fissures, and redness
• Changes to vaginal discharge, which may be thick, white, or yellowish in color

Types of VVC

Vulvovaginal candidiasis can manifest as an acute, chronic, recurrent, or persistent condition. It can involve the vulva, vagina, and adjacent crural areas.

Causes and Risk Factors

While the exact cause of VVC is not fully understood, it is believed to be related to an overgrowth of Candida in the vagina. Certain factors may increase the risk of developing VVC, including:

• Hormonal changes during menstruation or menopause
• Antibiotic use
• Poor hygiene
• Weakened immune system

References

• [1] Overview of vaginal yeast infection symptoms and causes.
• [3] Description of vaginal yeast infection symptoms.
• [4] Common fungal infection caused by Candida overgrowth in the vagina.
• [7] Vulvovaginal candidiasis symptoms, including pruritus and irritation.
• [8] Types of vulvovaginal candidiasis, including acute, chronic, recurrent, or persistent conditions.

Common Signs and Symptoms of Vulvovaginal Candidiasis

Vulvovaginal candidiasis, also known as a vaginal yeast infection, is a common condition that affects many women. The symptoms can vary from woman to woman, but here are some common signs and symptoms:

• Abnormal Vaginal Discharge: A thick, white, or cottage cheese-like discharge is often the first sign of a vaginal yeast infection [2][5].
• Itching and Irritation: Itching, burning, or irritation in the vulvovaginal area can occur due to the overgrowth of Candida fungus [1][3][7].
• Pain during Urination: Pain or discomfort when urinating is another common symptom of a vaginal yeast infection [3][6].
• Pain during Sexual Intercourse: Pain or discomfort during sex can also be experienced by women with vulvovaginal candidiasis [3][6].
• Redness and Swelling: Redness, swelling, and irritation in the vulvovaginal area can occur due to the infection [1][2].

It's essential to note that these symptoms can vary from woman to woman, and not all women will experience all of them. If you suspect you have a vaginal yeast infection, it's crucial to consult with a healthcare professional for proper diagnosis and treatment.

References: [1] - Complicated yeast infection (search result 1) [2] - Vaginal candidiasis (yeast infection) (search result 3) [3] - Vulvovaginal candidiasis (VVC) (search result 4) [5] - Symptoms of vaginal yeast infections (search result 5) [6] - Vaginal yeast infections are common (search result 6) [7] - Vaginal yeast infection typically occurs due to the overgrowth of yeast in the vulvovaginal area. (search result 7)

Diagnostic Tests for Vulvovaginal Candidiasis

Vulvovaginal candidiasis (VVC) is a fungal infection caused by Candida species, and diagnosing it can be done through various tests. Here are some of the diagnostic tests used to diagnose VVC:

• Wet-mount test: This test involves microscopic examination of vaginal discharge or scrapings from vulvar lesions mixed with physiologic saline [7]. It is a simple and quick test that can help identify yeast cells in the vagina.
• Nucleic acid amplification tests (NAATs): These tests are highly sensitive and specific for diagnosing VVC. They detect the genetic material of Candida species in vaginal discharge or swabs [6].
• Vaginal pH testing: This test measures the acidity of the vagina, which can be elevated in cases of VVC. However, it is not a definitive diagnostic test as other conditions can also cause an increase in vaginal pH.
• Microscopy: Microscopic examination of vaginal discharge or swabs can help identify yeast cells and other microorganisms that may be present in the vagina [3].
• Culture: Culturing vaginal discharge or swabs on a fungal culture medium can help identify Candida species and confirm the diagnosis of VVC. However, it is not always necessary as NAATs are more sensitive and specific.
• Immunochromatography test (ICT): This test uses an immunological method to detect the presence of Candida antigens in vaginal discharge or swabs [4].

Other Tests

In addition to these tests, a healthcare provider may also perform a pelvic exam and take a sample of the discharge from your vagina to diagnose VVC. For thrush, the healthcare provider will look at the affected area for signs of infection.

References:

[1] 3. Diagnosis. To diagnose a yeast infection, your healthcare professional may: Ask about your medical history. This might include past vaginal infections or ... [2] 7. Sep 19, 2024 — The wet-mount test involves microscopic examination of vaginal discharge or scrapings from vulvar lesions mixed with physiologic saline, using ... [3] 6. by JD Sobel · Cited by 14 — Outline · Vaginal pH and microscopy · Nucleic acid amplification tests (NAATs) · Other tests · Limited role of culture. [4] 4. by A Marot-Leblond · 2009 · Cited by 78 — We have developed a sensitive immunochromatography test (ICT), the CandiVagi assay (SR2B, Avrille, France), for the rapid diagnosis of VVC using an ... [5] 8. Jan 7, 2022 — Vaginal yeast infection testing involves a series of tests used to diagnose the cause of vaginitis, which refers to irritation of the vagina ...

Treatment Options for Vulvovaginal Candidiasis

Vulvovaginal candidiasis (VVC) can be effectively treated with various medications, which are designed to target the fungal cells causing the infection. Here are some common treatment options:

• Oral Antifungals: Oral antifungal medications such as fluconazole (Diflucan), ibrexafungerp (Brexafemme), and oteseconazole (Vivjoa) can be taken to treat VVC. These medications work by killing the fungal cells that cause the infection.
• Topical Antifungals: Topical antifungal creams, ointments, or suppositories such as clotrimazole, butoconazole, and ketoconazole can also be used to treat VVC. These medications are applied directly to the affected area to help clear up the infection.

Key Points

• Oral treatment with fluconazole consists of a single dose of 150 mg [1].
• Ibrexafungerp (Brexafemme) is taken twice a day for 1 day and targets specific fungal cells behind the infection [3].
• Oteseconazole (Vivjoa) is another oral medication approved to treat VVC, which can be taken by mouth [2].

Medication Comparison

References

[1] Satora, M. (2023). Oral treatment with fluconazole consists in administering a single dose of 150 g of the drug.

[2] The U.S. Food and Drug Administration recently approved two medicines to treat vaginal yeast infections, one being oteseconazole (Vivjoa).

[3] Ibrexafungerp (Brexafemme) is taken twice a day for 1 day and targets specific fungal cells behind the infection.

[4] EN RINGDAHL. (2000). In one clinical trial, women with a history of recurrent vulvovaginal candidiasis were randomized to receive 400 mg of ketoconazole for 14 days.

[5] Sep 19, 2024. The oral triterpenoid agent, ibrexafungerp, is the first non-azole antifungal approved for vulvovaginal candidiasis (VVC) and the first drug to target specific fungal cells behind the infection.

[6] JD Sobel. (2023). New antifungals, ibrexafungerp and oteseconazole, are now available for treatment of vulvovaginal candidiasis.

[7] Antifungal medications work by fighting yeast overgrowth in your body.

[8] Treatment of vaginal candidiasis usually involves topical or oral antifungals.

Differential Diagnosis of Vulvovaginal Candidiasis

Vulvovaginal candidiasis (VVC) is a common cause of vaginal itching and discharge, but it can be challenging to diagnose accurately. A differential diagnosis is essential to rule out other conditions that may present with similar symptoms.

Common Infectious Differentials:

• Bacterial vaginosis (BV)
• Trichomonas vaginalis
• Sexually transmitted infections (STIs)

These conditions can cause similar symptoms, such as itching, redness, and discharge. However, they have distinct characteristics that can help in their diagnosis.

Other Conditions to Consider:

• Atrophic vaginitis: a condition characterized by thinning of the vaginal walls, leading to dryness and irritation.
• Contact dermatitis: an allergic reaction to substances that come into contact with the vulva or vagina.
• Provoked vestibulodynia: a condition characterized by pain or discomfort in the vulvar area.

Key Points to Consider in Differential Diagnosis:

• The presence of external dysuria and vulvar pruritus, pain, swelling, and redness are indicative of VVC.
• Vulvovaginal candidiasis can be differentiated from other conditions based on the type of discharge (thick curdy vs. thin and watery) and the presence or absence of unpleasant odor.
• A combination of clinical and laboratory criteria is necessary for an accurate diagnosis.

References:

• [7] Common infectious differentials for candidiasis are listed in this search result.
• [8] Bacterial vaginosis, Trichomonas vaginalis, and Sexually transmitted infections (STIs) are mentioned as differential diagnoses.
• [9] Candida Vulvovaginitis must be differentiated from diseases with similar presentation such as bacterial vaginosis, trichomonas vaginitis and atrophic vaginitis.
• [11] Various vulvovaginitis etiologies have similar symptoms, but distinct characteristics can help in their diagnosis.