Vaginal candidiasis

Vaginal candidiasis is a mycosis of the vaginal mucosa, which occurs when it is colonized by strains of the Candida yeast-like fungus. In some cases it helps to In the acute stage, there is redness, swelling and itching of the vulva, pain, burning and itching in the vagina, copious, curd-like vaginal discharge, and in the chronic stage there is dryness and atrophy of the mucous membrane, exoriations and pronounced lichenization. The diagnosis of vaginal candidiasis is established on the basis of the clinical picture, microscopic and cultural examination. In case of vaginal candidiasis systemic and local antimycotic agents, multivitamins, immunostimulants are prescribed.

General information
Vaginal candidiasis, or thrush, is a kind of vaginal fungal infection, the causative agent of which are microscopic yeast-like fungi of the genus Candida albicans. Candida infection is of great importance in obstetrics and gynecology due to its widespread and increasing incidence in recent years. Among vaginal infections, candidiasis ranks second after bacterial vaginosis. Vaginal candidiasis usually affects women of childbearing age (pregnant women 2-3 times more often), it rarely occurs before menarche and in postmenopause. Vaginal yeast infection may exist in the form of asymptomatic candiduria and true vaginal candidiasis – acute (lasting up to 2 months) and chronic recurrent (lasting more than 2 months).

Causes of vaginal thrush
Vaginal candidiasis is caused by Candida genus yeast-like fungi, which live on the skin and mucous membranes of the oral cavity, gastrointestinal tract, external genitalia and the vagina of healthy women. Alternating growth phases (pseudomycelium and blastospores) allow the fungi to survive in a wide temperature and acidic range. Boiling for 10-30 min, treatment with formalin, copper sulfate, carbolic acid and boric acid cause the death of candida. The presence of mannoprotein shell and enzymes (proteinases and catalases) of fungi makes it easier to resist the immune system of the macroorganism.

The dominant causative agents of vaginal candidiasis (in 75-80% of cases) are C. albicans strains, which have a high pathogenic potential. Vaginal candidiasis caused by other species (C. glabrata, C. tropicalis, C. krusei, C. parapsilosis) is more typical for certain ethnic groups (female members of the African race) and geographical areas (Mediterranean coast, Middle East), which is related to the specific microbiocenosis of the mucosa and skin, diet and living conditions.

Generally, vaginal candidiasis is an endogenous infection that develops in an asymptomatic candidiasis, usually vaginal, less often on the oral, intestinal and skin mucosa. For example, the recurrent form of vaginal candidiasis is due to persistence of candidiasis in the intestine and periodic entry of the pathogen into the vagina and its colonization. In vaginal candidiasis, candida pseudomycelium usually penetrates only the superficial layers of the vaginal epithelium, less frequently affecting deeper tissues with subsequent hematogenous spread and affecting various organs.

The occurrence of vaginal candidiasis is promoted by the insufficiency of the host’s defense system, manifested by a decrease in the local immunity of the vagina. Local immunodeficiency against candida antigens (reduced activity of macrophages and lymphocytes) does not allow to block the receptors and enzymes of fungi.

Vaginal candidiasis is usually not accompanied by a marked decrease in lactobacillus levels and changes in the normal vaginal microflora; however, it may be combined with bacterial vaginosis when polymicrobial associations are formed.

An imbalance of sex hormones in pregnancy, taking hormonal contraceptives, endocrine pathology have the potential to develop vaginal candidiasis. The influence of estrogen and progesterone fluctuations on the vaginal mucosa is manifested by an increase in the concentration of glycogen in the epithelial cells, the stimulation of their sensitivity to candida and a more effective adhesion of fungi. Vaginal candidiasis is much more likely to accompany various conditions associated with immunosuppression (HIV infection, diabetes, tuberculosis, hypovitaminosis, excessive use of antibiotics, corticosteroids, cytostatics, radiation therapy, etc.). Vaginal candidiasis may be associated with atopic manifestations (allergic rhinitis, food allergies).

Nutritional irregularities, the use of hygiene products (pads, tampons) and the wearing of tight clothes are not considered to be significant factors in the development of vaginal candidiasis. There is a possibility of Candida infection being transmitted to the newborn through the birth canal of a sick mother; sexual transmission is possible; the risk of infection is higher with frequent oral-genital contact.