Vulvovaginal Conditions: Yeast/candida

Vulvovaginal candidiasis (VVC) is the second most common cause of vaginal discharge, after bacterial vaginosis. It is an inflammatory condition of the vulva and vagina usually caused by Candida species and rarely other fungi. The symptoms of the infection are nonspecific and include vaginal pruritus, soreness, and discharge, external dysuria, and dyspareunia. The management of the infection depends on classification of infection as complicated or uncomplicated based on predisposing conditions and physical exam findings. Bacterial vaginosis is a frequent cause of vaginal discharge and recurrences are common. It results from alteration of the normal vaginal flora with replacement of hydrogen peroxide-producing lactobacilli with primarily anaerobic bacteria. If symptomatic, it is associated with a malodorous discharge and may be associated with irregular or prolonged menses and abdominal pain. Examination shows a white, yellow or gray homogenous discharge adherent to the vaginal wall. Diagnosis is made with microscopy using Amsel's clinical criteria. Treatment is indicated for any symptomatic patient, especially pregnant women, due to the association with miscarriage and preterm birth.