Vulvovaginitis candidiasica: patogenesis, recurrencias y tratamiento / Vulvovaginitis due to candida: pathogenesis, recurrence and treatment

RESUMO

One of the main causes for women consultation are genital infectious diseases manifested as vaginal discharge. Infection due to Candida species is currently regarded as the second commonest cause of vaginitis in Colombia. Therapy with antibiotics and oral contraceptives, hormone imbalances, physical factors and immunological defects are frequently associated to vulvovaginal candidiasis. For reasons that are not clear many women are colonized but only a small minority develop symptoms, that readily respond to topical intravaginal antifungal agents, and an even smaller number have frequent recurrent symptoms. Despite the fact that symptoms and signs are not specific, pruritus and white discharge are predominant complaints. Experimental studies have shown that 100 yeasts are the minimal inoculum for causing clinical manifestations of infection and that the incubation period is between one and four days. It is also known that for isolation of one colony in solid culture 100 yeatst per ml of vaginal discharge are required, while for direct microscopical observation 100,000 are necesary. Most symptomatic women have positive direct examination while it is exceptionally positive in asymptomatic cases; false negative direct examination is extremely rare in symptomatic patients. Culture is only needed in symptomatic women in whom the direct examination of vaginal discharge is negative and other etiologies...