Vulvovaginal candidiasis (VVC) is the infection of vulva and vagina caused by Candida species. According to the pathogen, host, severity and recurrence of the disease, it can be classified as uncomplicated and complicated. VVC caused by Candida albicans with sporadic onset (<4 times per year) and mild to moderate severity in otherwise normal host is classified as uncomplicated. Complicated VVC occurs in immunocompromised hosts, is caused by non-albicans Candida, occurs 4 times or more within a year, or has high severity1.
Candida belongs to the normal flora on human skin and vaginal mucosa. Symptoms would be present if the defense mechanism of the vaginal mucosa and the pathogenicity of fungi lost their balance1.
Vulvar pruritis and burning, can be accompanied with dysuria, dyspareunia and increased leucorrhea. In the examination, scratch or fissure, white membranous secretion on labia minor and vaginal mucosa can be observed. VVC is characterized by the caseous vaginal discharge2.
Antifungal agents should be used for VVC. Topical and oral antifungals can both provide sufficient effect. Pregnant women should choose vaginal azole agents without teratogenicity and avoid using oral antifungals. Vaginal lavage is not generally recommended. The treatment course should be prolonged for severe VVC compared to the uncomplicated cases. For recurrent VVC, a maintenance therapy for 6 months should be initiated after induction therapy.
1. Gon?alves B, Ferreira C, Alves C T, et al. Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors[J]. Critical reviews in microbiology, 2016, 42(6): 905-927.