Vulvovaginal Candidiasis

GENERAL PRINCIPLES

Vulvovaginal candidiasis is not generally considered an STI but commonly develops in the setting of antibiotic therapy. Recurrent infections may be a presenting manifestation of unrecognized HIV infection.

DIAGNOSIS

• Thick, cottage cheese-like vaginal discharge in conjunction with intense vulvar inflammation, pruritus, and dysuria is often present.

• Vaginal pH is normal.

• Definitive diagnosis requires visualization of fungal elements on a KOH preparation of the vaginal discharge.

TREATMENT

• Therapy is often initiated on the basis of the clinical presentation.

• Fluconazole failure may indicate the presence of a non-Candida albicans species.