Vaginal Candidiasis (VVC)

Vaginal Candidiasis (VVC)

• Also known as vulvovaginal candidiasis
• A fungal infection typically caused by Candida albicans
• Causes irritation, discharge, and itching of the vagina and vulva
• It is also known as vaginal yeast infection

Signs and Symptoms

• Yeast infection symptoms range from mild to moderate
• Itching and irritation in the vagina and vulva
• Burning feeling, especially during intercourse or urination
• Redness and swelling of the vulva, which may be harder to see on Black or brown skin
• Vaginal pain and soreness
• Thick, white vaginal discharge (shedding of fluid and cells) that resembles cottage cheese with little to no odor
• Complicated yeast infections can be characterized by:
  • Severe symptoms like redness, swelling, and itching leading to tears, cracks, or sores
  • Experiencing four or more yeast infections in a year
  • Pregnancy
  • Unmanaged diabetes
  • Weakened immune system due to HIV infection or certain medications

Transmission

• Sexual transmission is less common, but is possible via sexual contact if one partner has an active infection
• Mother-to-child transmission can occur during childbirth, potentially leading to oral thrush in the infant
• Environmental factors like tight clothing, poor hygiene, and douching can promote yeast overgrowth, increasing the risk of developing an infection

Risk Factors

• Prolonged use of antibiotics or medications that alter vaginal flora
• Diabetes, especially if uncontrolled
• Pregnancy and hormonal changes
• Use of hormonal birth control or hormone replacement therapy
• Weakened immune system (HIV, chemotherapy, etc.)
• Increased sexual activity, especially with multiple partners
• Poor hygiene practices
• Obesity
• Stress, which weakens the immune system
• Diets high in sugar or refined carbohydrates
• Tight clothing and excessive moisture

Diagnosis

• Medical history and symptoms assessment
• Physical examination, including a pelvic exam to check for visible signs of infection
• Laboratory Tests:
  • Microscopic examination
  • Culture
  • pH testing
• Testing for other infections to rule out conditions with similar symptoms, like STIs
• Testing for underlying conditions (diabetes, HIV) in cases of recurrent infections

Prevention

• Maintain good hygiene
• Avoid irritating products
• Manage diabetes
• Use antibiotics cautiously
• Wear loose, comfortable clothing
• Change out of wet clothes promptly
• Practice safe sex
• Probiotics
• Avoid stress
• Monitor hormonal changes

Treatment

• Antifungal medications:
  • Topical antifungals like clotrimazole (Lotrimin), miconazole (Monistat), and tioconazole (Vagistat)
  • Oral antifungals, such as Diflucan, typically prescribed as a single dose for mild infections
• Home remedies for supportive care:
  • Probiotics
  • Yogurt
• Lifestyle Modifications:
  • Good hygiene practices
  • Wearing loose-fitting clothing
• For recurrent infections:
  • Longer-term treatment
  • Check for underlying conditions

Chain of Infection

• Infectious Agent: Vaginal Candidiasis, most commonly Candida albicans
• Reservoir:
  • The human body, specifically the vaginal area, mouth, and digestive tract
  • Candida can be found in damp environments, though human-to-human transmission is more common
• Portal of Entry:
  • Typically through the vaginal mucosa, especially when the natural balance of vaginal flora is disrupted
  • In mother-to-child transmission, it enters through the baby's mouth, leading to oral thrush
• Portal of Exit: Through vaginal discharge
• Mode of Transmission
  • Direct or indirect contact