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Candida - the genital tract nightmare


Autor: ass dr Milan Stefanović    

candida-the-genital-tract-nightmare

Candida

Increased vaginal secretion (secret) is one of the most common genital problems. Most of the inflammation of the mucous membrane in the vagina can be divided into three groups:

  • Unspecified vaginitis – common in 40-50% of the cases
  • Candidiasis – 20-30%
  • Trihomoniasis – 20-30%

At least seven types of fungi can be isolated from the female vagina from time to time. This includes both pathogenic and non-pathogenic types of Candida. When it comes to the types whose occurrence is accompanied by difficulties in 90-95% it is Candida albicans and in 2-8% it is Candida glabrata. Three thirds of the women whom Candida has been isolated do not have any problems. Predilection places for Candida development are the environments rich in carbohydrates, thus, candidiasis is common with:

  • Pregnancy (the vagina is in pregnancy rich with glycogen)
  • Diabetes mellitus
  • Taking antibiotics of wide spectrum (suprimates normal flora)
  • Immunosuppressive therapy

The additional factors are: vaginal douching perfumed hygienic sprays, local antimicrobial therapy, tight clothes, and synthetic underwear.

Symptoms

The most common symptom is an itch and irritation in the area of the vagina and the vulvae. The secretion is white, thick as cheese, without any smell. Red spots can be seen on the wall of the vagina. pH of the vaginal secretion is < 4.5. About 20% of women do not have any symptoms.

Considering that the reservoir of Candida is the gastrointestinal tract – and having in mind that the permanent infection is around the vulvae and anus – recedives and reinfections are very common. The cause of the reinfection can be having sexual intercourse with a partner who is infected, although this is believed to be rare. If the diagnosis of the recidives is confirmed, oral glucose-tolerance test should be performed in order to see whether there are any carbon-hydrate metabolism disorders With this kind of infection it is wise to apply the systematic treatment in order to eliminate the intestine infection. The connection between menstruation and recidives (menstrual blood is alkali) induces the prophylactic cures during several cycles.

Diagnosis

It is decided upon based on the anamnesis, gynecological examination, and microscopic examination of the vaginal secretion.

Treatment

  • Nystatin- Panfarma
  • Klortrimazol:
    • Kansen- Zdravlje Actavis
    • Canesten 1- Bayer Pharma
    • Canesten 3- Bayer Pharma
    • Mycoril Remedica
  • Mikonazol: Gino-Daktanol- Galenika
  • Ekonazol: Ecalin- Jugoremedia
  • Fentikonazol: Lomexin- Recordati Spa
The typical antifungal therapy by using klortrimazol and miconazol as well as fluconazol is very successful. The therapy with nistatine and iodine-povidine is less successful. About 15% of Candida organisms are resistant to klortrimazol and miconazol. Chronic or recurrent infections require longer treatment or the systematic antimicotic must be used, that is, Fluconasol 150mg a week within 12 consecutive weeks.

The facts about vaginal fungal infections

Three out of four women suffer from a fungal infection at least once in their life, any woman can be infected. Candida albicans is the most common cause, fungi are normally present in the vagina but when they start multiplying an infection appears, the symptoms are recognizable.

Recommended therapy with fungal infections

My advice is to use Diflucan 150mg as a primary therapy, use it in one dosage for both partners. A woman continues taking Canesten, three vaginal tablets, two packs with a two day pause between these two packs. Within the next 3-4 periods one vaginal tablet immediately after the end of the period. If this treatment does not help, the type of antimicotics should be changed.

Nourishment for candida infection must be proper and will drastically contribute to the recovery of patient.


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