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Vaginal itching

The wet prep revealed pseudohyphae with budding, the hallmark of a candida infection; the patient was given a diagnosis of vulvovaginal candidiasis (VVC).

 

VVC is a common fungal infection in women of childbearing age; it is not a sexually transmitted disease. Patients with VVC will complain of pruritus, accompanied by a thick, odorless, white vaginal discharge.

Based on clinical presentation, microbiology, host factors, and response to therapy, VVC can be classified as either uncomplicated or complicated:

  • Uncomplicated VVC is characterized by sporadic or infrequent symptoms that are mild to moderate. Patients are not immunocompromised.
  • Complicated VVC is characterized by recurrent (≥4 episodes in one year) or severe VVC and may involve non-albicans Candidiasis, or a patient who has uncontrolled diabetes, debilitation, or immunosuppression.

Treatment options include topical over-the-counter azole antifungal creams and a single dose of fluconazole 150 mg orally. In this case, the patient bought over-the-counter antifungal cream and her symptoms cleared quickly.

 

Photo and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Mayeaux EJ, Usatine R. Candida vulvovaginitis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:499-503.

To learn more about the Color Atlas of Family Medicine, see: http://www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/

You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: http://usatinemedia.com/

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The Journal of Family Practice - 63(12)
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The wet prep revealed pseudohyphae with budding, the hallmark of a candida infection; the patient was given a diagnosis of vulvovaginal candidiasis (VVC).

 

VVC is a common fungal infection in women of childbearing age; it is not a sexually transmitted disease. Patients with VVC will complain of pruritus, accompanied by a thick, odorless, white vaginal discharge.

Based on clinical presentation, microbiology, host factors, and response to therapy, VVC can be classified as either uncomplicated or complicated:

  • Uncomplicated VVC is characterized by sporadic or infrequent symptoms that are mild to moderate. Patients are not immunocompromised.
  • Complicated VVC is characterized by recurrent (≥4 episodes in one year) or severe VVC and may involve non-albicans Candidiasis, or a patient who has uncontrolled diabetes, debilitation, or immunosuppression.

Treatment options include topical over-the-counter azole antifungal creams and a single dose of fluconazole 150 mg orally. In this case, the patient bought over-the-counter antifungal cream and her symptoms cleared quickly.

 

Photo and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Mayeaux EJ, Usatine R. Candida vulvovaginitis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:499-503.

To learn more about the Color Atlas of Family Medicine, see: http://www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/

You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: http://usatinemedia.com/

The wet prep revealed pseudohyphae with budding, the hallmark of a candida infection; the patient was given a diagnosis of vulvovaginal candidiasis (VVC).

 

VVC is a common fungal infection in women of childbearing age; it is not a sexually transmitted disease. Patients with VVC will complain of pruritus, accompanied by a thick, odorless, white vaginal discharge.

Based on clinical presentation, microbiology, host factors, and response to therapy, VVC can be classified as either uncomplicated or complicated:

  • Uncomplicated VVC is characterized by sporadic or infrequent symptoms that are mild to moderate. Patients are not immunocompromised.
  • Complicated VVC is characterized by recurrent (≥4 episodes in one year) or severe VVC and may involve non-albicans Candidiasis, or a patient who has uncontrolled diabetes, debilitation, or immunosuppression.

Treatment options include topical over-the-counter azole antifungal creams and a single dose of fluconazole 150 mg orally. In this case, the patient bought over-the-counter antifungal cream and her symptoms cleared quickly.

 

Photo and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Mayeaux EJ, Usatine R. Candida vulvovaginitis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:499-503.

To learn more about the Color Atlas of Family Medicine, see: http://www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/

You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: http://usatinemedia.com/

Issue
The Journal of Family Practice - 63(12)
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The Journal of Family Practice - 63(12)
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