Vaginitis: Monilial

Chapter 95 Vaginitis: Monilial



INTRODUCTION



Description: Monilial vaginitis is a vaginal infection caused by ubiquitous fungi found in the air or as common inhabitants of the vagina, rectum, and mouth.

Prevalence: Twenty-five percent to 40% of “vaginal infections;” 75% of women experience one or more lifetime occurrences.

Predominant Age: 15 to 50 (rare outside this range except for those receiving estrogen replacement after menopause).

Genetics: No genetic pattern.


ETIOLOGY AND PATHOGENESIS



Causes: Candida albicans (80% to 95%), Candida glabrata, Candida tropicalis, or others (5% to 20%).

Risk Factors: Altered vaginal ecosystem (stress, antibiotic use, pregnancy, diabetes, depressed immunity, topical contraceptives, and warm and moist environment).


CLINICAL CHARACTERISTICS



Signs and Symptoms (15% asymptomatic carrier rate)



• Vulvar itching or burning (intense)

• External dysuria, dyspareunia

• Tissue erythema, edema, and excoriations

• Thick, adherent, plaquelike discharge with a white to yellow color (generally odorless)

• Vulvar excoriations


DIAGNOSTIC APPROACH



Differential Diagnosis



• Bacterial vaginitis

• Bacterial vaginosis

• Trichomonas vaginal infection

• Contact vulvitis (allergic vulvitis)

• Atrophic vulvitis

• Vulvar dermatoses

• Pinworms


Associated Conditions: Diabetes, immunosuppression or compromise (as risk factors for infection), chronic vulvitis.


Workup and Evaluation



Laboratory: Culture (Nickerson’s or Sabouraud media) or monoclonal antibody staining may be obtained but are seldom necessary.

Imaging: No imaging indicated.

Special Tests: Vaginal pH 4 to 4.5.

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Vaginitis: Monilial

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