Vaginal candidiasis is commonly referred to as ‘thrush’; it refers to vaginal infection with a yeast of the Candida family
Aetiology
The most common organism is Candida albicans
Risk factors
Increased oestrogen (higher in pregnancy, lower pre-puberty and post-menopause)
Poorly controlled diabetes
Immunosuppression (e.g. using corticosteroids)
Broad-spectrum antibiotics
Pathophysiology
Candida may colonise the vagina without causing symptoms
It then progresses to infection when the right environment occurs, for example, during pregnancy or after treatment with broad-spectrum antibiotics that alter the vaginal flora
Clinical features
Thick, white discharge that does not typically smell
Vulval and vaginal itching, irritation or discomfort
Investigations
Often treatment for candidiasis is started empirically, based on the presentation
In suspected bacterial/resistant or complicated infection, take swabs from the anterior fornix or lateral vaginal wall and send for microscopy, culture and sensitivity
Management
Antifungal cream (i.e. clotrimazole) inserted into the vagina with an applicator