Upon completion of the chapter, the reader will be able to:
Explain the underlying pathophysiology of vulvovaginal candidiasis, oropharyngeal candidiasis, esophageal candidiasis, and fungal skin infections.
Identify symptoms of vulvovaginal candidiasis, oropharyngeal candidiasis, esophageal candidiasis, and fungal skin infections.
Identify the desired therapeutic outcomes for patients with uncomplicated and complicated vulvovaginal candidiasis, oropharyngeal candidiasis, esophageal candidiasis, and fungal skin infections.
Recommend appropriate lifestyle modifications and pharmacotherapy interventions for patients with vulvovaginal candidiasis, oropharyngeal candidiasis, esophageal candidiasis, and fungal skin infections.
Recognize when long-term suppressive therapy is indicated for a patient with vulvovaginal candidiasis.
Recognize when topical versus oral treatment is indicated for a patient with oropharyngeal candidiasis, esophageal candidiasis, vulvovaginal candidiasis, and fungal skin infections.
Educate patients about the disease state, appropriate lifestyle modifications, and medication therapy required for effective treatment of vulvovaginal candidiasis, oropharyngeal candidiasis, esophageal candidiasis, and fungal skin infections.
Superficial fungal infections, also referred to as mycoses, are common and treatable conditions seen in everyday practice. Treatment largely depends on the use of azole and allylamine antifungal agents, either topically or orally, depending on the site, severity, and immune status of the patient.
Vulvovaginal candidiasis (VVC), whether symptomatic or asymptomatic, refers to infections in women whose vaginal cultures are positive for Candida species.
EPIDEMIOLOGY AND ETIOLOGY
Vulvovaginal candidiasis, also known as moniliasis, is a common form of vaginitis, accounting for 20% to 25% of vaginitis cases. Although VVC is uncommon prior to menarche, an estimated 75% of women will have at least one occurrence of VVC.1
According to the treatment guidelines of the Centers for Disease Control and Prevention (CDC),1 VVC can be classified as uncomplicated or complicated. Uncomplicated infections occur sporadically, cause mild to moderate symptoms, and occur in nonimmunocompromised women. Uncomplicated infections, most often caused by Candida albicans, often have no identifiable precipitating cause. Complicated infections, including recurrent, severe infections, and those in women with uncontrolled diabetes, debilitation, or immunosuppression, may be caused by nonalbicans or azole-resistant fungal organisms. Recurrent VVC, defined as four or more infections per year, occurs in less than 5% of women, is distinguishable from a persistent infection by the presence of a symptom-free interval between infections.1
KEY CONCEPT Candida albicans is the primary pathogen responsible for VVC, accounting for 66% of cases.2 Other cases are caused by nonalbicans species, including Candida glabrata, Candida tropicalis, Candida krusei, and Candida parapsilosis.2
Clinical Presentation and Diagnosis of VVC
Patients with VVC may present with vulvar and/or vaginal symptoms. Symptoms often develop the week before menses and resolve with the onset of menses. Symptoms
Log In to View More
If your institution is currently a subscriber
of Pharmacotherapy Principles & Practice please sign in below.
If your institution is not a subscriber
please click here
to learn more.
Want remote access to your institution's subscription?
Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.
If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.
Pop-up div Successfully Displayed
This div only appears when the trigger link is hovered over.
Otherwise it is hidden from view.