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Candidal vulvovaginitis is an infection of the vulva and vagina that can cause pain, redness, discomfort, and a white discharge. The condition develops as a result of infection from a species of yeast called Candida albicans. It is most commonly referred to as a yeast infection, but can also be called vaginal thrush. Although candidal vulvovaginitis can cause a significant amount of irritation, it is typically easily treated by either applying topical antifungal creams or taking antifungal pills.
The reason why women develop candidal vulvovaginitis is that they have an overgrowth of the yeast species Candida albicans in the vaginal region. This yeast is often present in small numbers in asymptomatic women without vulvovaginitis. Certain conditions can promote the overgrowth of this yeast, including wearing restrictive clothing that prevents airflow in the vaginal region, having a disease or taking a medication that suppresses the immune system, or having poor hygiene habits.
One of the primary manifestations of candidal vulvovaginitis is inflammation of the vulva and the vagina. The skin often appears red and irritated, and there can be associated itchiness, pain, and burning upon urination. Skin irritation is often accompanied by an abnormal thick white vaginal discharge resembling cottage cheese, and some people report that it smells like bread.
A diagnosis of candidal vulvovaginitis is often made on the basis of clinical history, especially if the affected woman describes characteristic symptoms and has a thick white vaginal discharge. The diagnosis can be confirmed by taking a sample of the vaginal discharge and examining it under a microscope to inspect it for the presence of yeast. Confirming the diagnosis is often important the first time the women exhibits these symptoms in order to differentiate a yeast infection from other conditions, such as bacterial vaginosis or sexually transmitted infections. Recurring episodes can often be treated without confirming the diagnosis.
There are a variety of treatment options for candidal vulvovaginitis. A number of over-the-counter creams and vaginal suppositories are available which include antifungal active ingredients, such as clotrimazole, butoconazole, miconazole, tioconazole, or fluconazole. Patients with more severe symptoms could also be prescribed pills containing fluconazole.
Women typically have few complications due to candidal vulvovaginitis, although there are a couple of exceptions. People with poorly functioning immune systems, such as women with acquired immunodeficiency syndrome (AIDS), could have prolonged symptoms, and in severe cases the infection could spread to the blood and other areas of the body. Pregnant women could also experience complications, as there is an increased risk for preterm delivery in women with candidal vulvovaginitis. For this reason, pregnant women are monitored for development of this condition and promptly treated if they develop symptoms.