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  • Bashhcandidiasis 35685

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    Usman AR Vaince
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    This document summarizes the diagnostic and treatment pathways for vulvovaginal candidiasis (VVC). It outlines that the first-line diagnostic for acute VVC is microscopy to check for fungal elements, and first-line treatment is a single dose of fluconazole. For recurrent VVC, further diagnostics including culture and sensitivity testing are recommended. Treatment involves a fluconazole regimen for susceptible Candida, or other antifungals like boric acid or nystatin for resistant cases. Refractory cases may require alternative diagnoses to be considered.

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    This document summarizes the diagnostic and treatment pathways for vulvovaginal candidiasis (VVC). It outlines that the first-line diagnostic for acute VVC is microscopy to check for fungal elements, and first-line treatment is a single dose of fluconazole. For recurrent VVC, further diagnostics including culture and sensitivity testing are recommended. Treatment involves a fluconazole regimen for susceptible Candida, or other antifungals like boric acid or nystatin for resistant cases. Refractory cases may require alternative diagnoses to be considered.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    2 views1 page

    Bashhcandidiasis 35685

    Uploaded by

    Usman AR Vaince
    This document summarizes the diagnostic and treatment pathways for vulvovaginal candidiasis (VVC). It outlines that the first-line diagnostic for acute VVC is microscopy to check for fungal elements, and first-line treatment is a single dose of fluconazole. For recurrent VVC, further diagnostics including culture and sensitivity testing are recommended. Treatment involves a fluconazole regimen for susceptible Candida, or other antifungals like boric acid or nystatin for resistant cases. Refractory cases may require alternative diagnoses to be considered.

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    © All Rights Reserved
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    Summary of the vulvovaginal candidiasis diagnostic and management pathway

    Presentation Diagnostics Therapy

    Microscopy for 1st line: fluconazole


    Acute VVC
    blastospore/ 150 mg PO stat; 2nd
    pseudohyphae (in level line: clotrimazole
    3 GUM setting) 500 mg PV[A]

    Fluconazole Suppressive therapy


    Microscopy susceptible with induction
    and HVS for Candida (150 mg 3x/week)
    Recurrent VVC fungal culture, then weekly 150 mg
    (good/complete fluconazole for 6
    identification (to at
    response to Tx) months[A]
    least C. albicans/
    non-albicans),
    sensitivity testing Fluconazole
    for fluconazole resistant
    Candida 100,000 IU nystatin
    pessaries for 14
    nights[A]

    Microscopy
    and HVS for
    fungal culture, Azole resistant
    identification and Candida
    Recurrent VVC
    full sensitivity
    (poor/partial
    response to Tx)
    testing

    600 mg boric acid


    Nystatin pessaries for 14
    resistant nights[A]
    Candida

    Consider alternative
    or additional
    diagnoses (lichen
    sclerosus, vulval pain
    syndromes, etc)

    Abbreviations: GUM=genitourinary medicine, HVS=high vaginal swab, PO=per os (by mouth), PV=per
    vagina, Tx=treatment, VVC=vulvovaginal candidiasis
    [A] See relevant section in the full guideline for more detail and other treatment options

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