Causes and symptoms of candidal vaginitis

Candidal vaginitis is also called vulvovaginal candidiasis in clinical practice, and is often called candidal vaginitis. Patients with candidal vaginitis develop the disease due to long-term ecological bacterial imbalance, decreased vaginal antibody capacity, and loss of the natural shielding system. The main causes include bacterial infection and gynecological diseases. Patients should undergo clear examinations and test bacteria under a microscope on a regular basis, and find relevant treatment methods based on the amount of bacteria.

1. Causes

80%-90% of the pathogens are Candida albicans, and 10%-20% are Candida glabrata, Candida parapsilosis, and Candida tropicalis. Candida albicans has spore phase and hypha phase. The hyphae are in the pathogenic state and have strong ability to invade tissues.

2. Characteristics of Candida

It is not very resistant to heat and will die if heated to 60℃ for one hour; but it is resistant to dryness, sunlight, ultraviolet rays and chemical reagents.

3. Predisposing factors

Candida albicans is a conditionally pathogenic bacterium. About 10% of non-pregnant women and 30% of pregnant women have this fungus parasitic in the vagina, but the amount of bacteria is very small, in the form of spores, and does not cause symptoms. Only when the systemic and local vaginal immunity is reduced, especially the local immunity is reduced, Candida albicans will multiply in large numbers and turn into hyphae phase, and symptoms of vaginitis will appear. Common predisposing factors include pregnancy, diabetes, large-scale use of immunosuppressants, and use of broad-spectrum antibiotics.

Clinical manifestations

The most common symptoms of candidal infection are excessive vaginal discharge, burning and itching of the vulva and vagina, exogenous dysuria, and geographic erythema of the vulva. Typical leucorrhea is curd-like or bean curd-like, the vaginal mucosa is highly red and swollen, and white thrush-like plaques can be seen attached, which are easy to peel off. Underneath is an eroded base of damaged mucosa, or shallow ulcers may form. In severe cases, ecchymosis may remain. However, not all leucorrhea has the above typical characteristics. It can range from watery to curd-like leucorrhea. Some are completely thin and clear serous exudates, which often contain white flakes. The itching symptoms of candidal vaginitis during pregnancy are particularly severe, and may even cause restlessness and abnormal pain. There may also be symptoms such as frequent urination, painful urination, and pain during sexual intercourse. In addition, about 10% of women and 30% of pregnant women are carriers of mold but have no clinical symptoms.

examine

In case of severe and persistent vulvar itching, fungal infection should be considered first. The diagnosis can be confirmed by direct smear examination and culture of local secretions. The hyphae branches and spores of fungi can be easily seen under the microscope. Candida albicans is oval in shape and Gram-negative, but the staining is often uneven. It is about 3 to 5 μm (several times larger than Staphylococcus aureus). It often produces sprouts that do not fall off (spores), so that it looks like hyphae but is not hyphae, so it is called pseudohyphae.