Vaginal Yeast Infection: Candida Albicans

Fungus is normally found in small amounts in the vagina. The naturally acidic environment maintains a healthy balance of 'good' and 'bad' microorganisms. If the environment is disrupted, and there is a change in the normal host flora, yeast can grow rapidly. Too much yeast irritates the vaginal tissues, leading to symptoms. A good supply of sugar also encourages yeast growth (i.e. people with diabetes who excrete sugar in their urine). When Candida Albicans, the usual microorganism responsible in cases of thrush, becomes overgrown on the mucosa of the vaginal walls, desquamation of the epithelial cells and accumulation of bacteria, keratin and necrotic tissue occurs. This debris forms a pseudo-membrane, which adheres closely to the mucosa. This in turn leads to oedema, ulceration and necrosis of the underlying mucosa.


Risk Factors:
Conditons which suppress the autoimmune system, e.g. HIV/AIDS, diabetes.
Menstruation.
Birth Control Pill.
Intra-uterine device.
Poor hygiene.
Anti-biotic treatment.
Tight clothing.
Pregnancy.
Douching.


Prevention:
Avoid tight, synthetic clothing.
Remove damp clothing bathing suits promptly.
Don't douche.
Avoid harsh soaps.
Wipe front to back on elimination.
Eat yogurt with bacterial culture.
Do not leave tampons in too long.
Use thrush treatments when taking antibiotics.


Signs and Symptoms:
Itching around the vagina.
Dysuria (pain on passing urine).
Vaginal discharge - thick and white.
Pain during intercourse.
Red/irritated labia.


Differential Diagnosis:
Bacterial vaginosis.
Trichomoniasis.
Chlamydia/gonorrhea.
Urinary Tract Infection.

Treatment:
Vaginal cream: miconazole. 1-2 weeks.
Vaginal pessary: Nystatin. 2 weeks.
Oral treatment: Fluconazole. Single dose.