Candida vaginitis
Introduction
Introduction to Candida Vaginitis Candida is a single-celled fungus that exists in healthy human skin, mucous membranes, and vagina. Under certain conditions, Candida can invade human tissues and cause inflammation. Its infection in the female reproductive tract often invades the vagina, and secondary inflammation of the mucous membrane of the vulva. It is called vulvovaginal candidiasis. It has been used in the past. Names such as fungal vaginitis, fungal vaginitis and fungal vaginitis. Candida vaginitis is easy to relapse before menstruation after treatment, so the vaginal discharge should be reviewed before menstruation. About 5%-10% recurrence after treatment with Candida vaginitis. For recurrence cases, the cause should be checked, such as whether there is diabetes, application of antibiotics, estrogen or steroid hormones, wearing tight chemical fiber underwear, stimulation of topical drugs, etc., to eliminate the incentives. Sex partners should be examined and treated for Candida. Because intestinal candida and deep vaginal candida are important sources of repeated infections, antifungal agents are mainly systemic. basic knowledge The proportion of illness: 0.3% Susceptible people: women Mode of transmission: contact, sexual transmission, mother-to-child transmission Complications: infertility, premature delivery, pelvic inflammatory disease, genital itching
Cause
Candida vaginitis cause
80-90% of VVC is caused by Candida albicans, and a small number of VVC can be caused by Candida glabrata, Candida parapsilosis or Candida tropicalis. Candida albicans is an oval-shaped single-walled cell, distributed in groups, with blastospores and pseudohyphae formed by cell germination elongation. Candida is not heat-resistant and can be killed by heating to 60 ° C for 1 hour, but it is more resistant to dryness, sunlight, ultraviolet rays and chemicals.
About 10% of non-pregnant women and 30% of pregnant women have Candida parasites in the vagina and are asymptomatic. When the amount of glycogen in the vagina increases and the pH decreases, Candida is easy to multiply and cause inflammation, so it is more common in pregnant women, diabetic patients and estrogens. After a large number of long-term antibiotics, the normal flora in the vagina is inhibited and the candida is excessive. Growth; long-term use of immunosuppressants or glucocorticoids can reduce the immune function of patients. These factors can cause vaginal infection and VVC.
Indirect contact (20%):
Indirect contact infection is also a route of transmission of candida vaginitis. Toilets, bath tubs, bath chairs, towels, and unclean toilet paper that are in contact with a common toilet infected with Candida patients can cause spread.
Sexual transmission (20%):
Sexual transmission is also one of the reasons for this. At least 10% of women with symptoms of the disease have candidiasis urethritis, and reasonable treatment should be given to prevent cross-infection.
Abuse of antibiotics (10%):
Take a lot of antibiotics. Taking antibiotics changes the microenvironment of the vagina, and the pathogenic bacterial pathogens may multiply, eventually leading to local episodes of candida vaginitis.
Excessive hygiene (15%):
Some women often use medicated lotion to clean the vagina in order to maintain hygiene. This is easy to destroy the acid and alkali environment of the vagina, but it is easy to get infected with candida vaginitis.
Disease factor (10%):
Diabetes and pregnancy may cause an increase in the rate of colonization of Candida in the vagina.
Prevention
Candida vaginitis prevention
Precautions:
1. During treatment, attention should be paid to the simultaneous treatment of both couples to avoid cross-infection and prohibit sexual life.
2, for patients with recurrence, oral medication combined with topical medication.
3, do not wear tight underwear, do not use dirty washing equipment.
4. If you can develop good hygiene habits from yourself, don't wear too tight clothes, sanitary toilet habits, regular cooking, don't eat too much barbecue or taste too much food, etc. The cure for vaginitis and avoid recurrence.
5. Choose pure cotton underwear, loose clothing, healthy sex, and uncomfortable symptoms.
Complication
Candida vaginitis complications Complications, infertility, premature pelvic inflammatory, genital itching
1, causing infertility
The vagina has a relatively safe environment under normal conditions, the flora is relatively balanced, and the pH is relatively balanced. This environment, which is suitable for the temporary retention and passage of sperm, is very important. Once this environment is destroyed, it is prone to infertility. If you have candidal vaginitis, changes in the pH of the vagina will inhibit sperm motility, and inflammatory cells can phagocytose sperm and weaken sperm motility, Candida albicans has agglutinating sperm, and inflammation occurs. Sexual intercourse pain and loss of libido can affect pregnancy. This type of infertility can quickly return to normal after active treatment. However, infertility caused by Candida vaginitis is temporary, and the disease can still be conceived after the disease is cured.
2, affect fetal development
After the pregnant woman is sick, a very small number of people in the vagina can go up through the cervix, penetrate the fetal membrane to infect the fetus, causing premature birth. In addition, when the fetus is delivered to the mother through the vagina, it may also be infected with Candida, causing oral candidiasis, as the so-called thrush is caused by oral Candida infection. Some babies may also have candida dermatitis around the anus. Thus, in order to avoid infection of the fetus, pregnant women should be actively treated after suffering from candidal vaginitis.
3, causing other diseases
If Candida vaginitis is not treated for a long time, it may cause inflammation to rise, causing cervicitis and cervical erosion. If the pathogen enters the uterine cavity, it will cause inflammation of the fallopian tube and ovary, pelvic inflammatory disease, etc., and finally affect pregnancy.
4. Affect the quality of life
Candidia vaginitis, accompanied by genital itching and other symptoms, will cause a lot of inconvenience and impact on women's life and work, it will also affect the husband and wife life.
Symptom
Candida vaginitis symptoms common symptoms vaginal ulcer vulva burning irritating lower body odor pruritus urgency vaginal intercourse pain pain urinary pain labia black
symptom
Itching of the vulva, there are more white bean dregs-like vaginal discharge is the main symptom of the disease. May be accompanied by burning sensation of the vulva, urgency, dysuria and painful intercourse. When the symptoms are severe, you may feel restless and painful.
Sign
Check the swelling of the vulva, the epidermis can be peeled off, and there are scratches. The inside of the labia minora and the vaginal mucosa are accompanied by a white membrane. After the eradication, the vaginal mucosa is swollen or erosive and superficial ulcers. Typical leucorrhea is white, clot-like and bean dregs, with a slight odor.
Examine
Candida vaginitis check
For atypical cases, in order to confirm the diagnosis, those suspected of having mold, or understanding the therapeutic effect, must be examined for vaginal secretions. Can directly take the vaginal secretions on the slide, add a small drop of isotonic sodium chloride solution or 10% ~ 20% potassium hydroxide solution, add a cover glass, micro-heat microscopy, red, white blood cells and epithelial cells dissolve immediately, and The mold is shown in the form of a wire-like fiber or mycelia, and is attached with micro-buds or molecular conidia. However, this method is less reliable (60%).
For example, the smear of vaginal secretions is stained with Gram. Under the microscope, a group of gram-positive densely stained oval-shaped spores can be found, or the pseudohyphae and the budding cells can be connected into a chain or branch, which is easy to identify. Reliability can be increased to 80%.
The most reliable method is to carry out mold culture. In addition, we must also pay attention to the relevant incentives, such as the application of large doses of steroids or broad-spectrum antibiotics history, and diabetes patients need to do urine sugar and blood sugar check.
Diagnosis
Diagnosis and identification of Candida vaginitis
Diagnostic criteria
The typical VVC diagnosis is not difficult, but it is easy to be mixed with other vulvar lesions, so it is necessary to do a pathogen examination to confirm the diagnosis. Direct vaginal discharge smear examination can be diagnosed.
a. Using the 10% KOH hanging drop method to find spores and pseudohyphae under the microscope, the positive rate can reach 60%.
b. Gram staining method, the positive rate can reach 80%.
c. The culture method has a higher positive rate and can identify sensitive antifungal drugs, but it takes a while to confirm the diagnosis and can be used for refractory VVC or recurrent VVC.
d. For stubborn cases, actively search for the history of the use of estrogen or antibiotics, and check blood sugar to exclude diabetes.
