Vaginal yeast infections fungal infections indication CandidamykoseEin vaginal thrush is a yeast fungi by, usually Candida albicans or other Candida species, caused infection of the vagina and the vulva. It manifests itself in symptoms such as itching and burning and redness, swelling and discharge. It will address the disease usually with fungal agents or alternatively with antiseptics. Fungal be applied on the one hand locally and available without a prescription in the form of vaginal tablets or Vaginalcrèmen. On the other hand, the intake of capsules or tablets is possible, which must be prescribed by a doctor. It should be noted that numerous other diseases cause a similar clinical picture. synonym: mycosis, Genitalmykose, vaginal candidosis, Vulvovaginal Candidiasis, vaginal mycosis symptoms An acute uncomplicated vaginal mycosis occurs more frequently in women of childbearing age. In girls and postmenopausal women is however rare. Approximately 75% of all women suffer once in their lives on a vaginal thrush. The clinical presentation is different. The symptoms include:
Itching and burning (Keynotes) Inflammation of the vagina and vulva with symptoms such as burning, redness, swelling and pain, whitish lining No to mild to strong, low-viscosity, aqueous effluent to Chunky Only faint odor Pain during intercourse Burning in micturition In severe forms can lead to erosions of the vagina and skin changes in the vaginal area and thighs. Other possible complications include chronic recurring vaginal mycoses and loss of quality of life. Causes and transmission It is an infection with yeast, in about 85% to 95% of cases with Candida albicans, Candida glabrata with rare or other Candida species. Vaginal candidiasis among the opportunistic infections. The fungi can occur naturally in the vagina in many women; only facilitated by a number of factors results in an infection. Risk factors include:
Numerous other factors are discussed, but are controversial. The fungi can come possibly from the rectum, from the vagina (relapse) or the penis of the partner. Although it is known that men can be infected asymptomatic and the role but actually makes it in the transfer is uncertain. diagnosis The diagnosis is made in medical treatment based on the patient history and clinical inspection, microscopy of the vaginal secretions and possibly by growing a fungal culture. Microscopy is often negative despite active infection. differential diagnoses It is not possible to make a diagnosis solely on the basis of symptoms and a study from the 1990s showed that misdiagnosed the majority of women themselves. Probably other causes of vaginitis are too little known. An empirical self-treatment is possible, but an accurate evaluation requires a gynecological examination. As exciting a vaginal infection, bacteria (for example, gonorrhea, genital chlamydia infection), viruses come (for example, genital herpes) and parasites (for example, trichomoniasis) in question. Other differential diagnoses include a bladder infection and skin diseases such as atrophic, allergic or irritative vaginitis, trauma, foreign body, warts, scabies and lice. Medication
For the treatment of acute uncomplicated and fungal infectious agents (antimycotics) are applied mainly to be administered either locally or orally. Both treatment options are about equally effective and have advantages and disadvantages (Nurbhai et al. , 2007). The co-treatment of the partner is only necessary if this also shows symptoms. These include itching, burning, redness and white film on the penis (balanitis mycotica). For treatment of special patient groups (eg pregnant women, diabetes, immunosuppression, chronic disease), we refer to the literature. Symptomatic treatment among other glucocorticoids against the lesions, cleansing lotions and skin care products are applied. Local antifungals Topical antifungals are administered locally vulvovaginal. Creams used for topical treatment of a vaginal tablet, an ovule or a vaginal cream are administered internally in the vagina. Clotrimazole (as gyno Canesten®, Fungotox®) is one of the means used in practice most frequently because it is available without a prescription from the age of 18 years. There are numerous alternatives to prescription: butoconazole (Gynazole®), econazole (Gyno-Pevaryl®), miconazole (Monistat®) oxiconazole (Oceral®) Ciclopirox (Dafnegil®), Nystatin. The duration of treatment varies depending on the drug and dosage form and may be 1, 3, amounted to 15 days. According to literature, the differences in efficacy marginal.
The local application poses less risk of adverse effects. Hypersensitivity reactions and local irritation may occur. Systemic antifungal agents: In the inner treatment tablets or capsules to be taken. Among the active compounds used include fluconazole (Diflucan®, generics) and itraconazole (Sporanox® G, generics). This treatment method is less cumbersome, but when taking more adverse effects and interactions with other drugs are possible. Doses are usually either as a single dose (fluconazole, 1 x 1) or on two consecutive days (itraconazole, 2 x 2). Other antifungal agents are also permitted in different treatment regimens, for example, Ketoconazole (Nizoral®, taking for 5 days). Antiseptics: In addition to the antifungal some antiseptics for local treatment in the form of Vaginalovula or tablets are used as an alternative. These include dequalinium (Fluomizin®), povidone-iodine (Betadine ovules), boric acid, octenidine and hexetidine (Vagi-HEX®). Alternative Medicine: In alternative medicine are (wrapped in gauze and crushed), for example, garlic, tea tree oil (a few drops in a bath or a vaginal gel or in Johannisöl) applied. Possible side effects include local irritation. The effectiveness of these methods do not have information. prevention
For prevention, there is a series of behavioral recommendations that are occupied but from our perspective is limited. Systemic antifungals such as fluconazole also be taken preventively. Probiotics like lactobacillus (Lactobacillus acidophilus) are introduced in the form of yogurt on the tampon or ovules (as Gynoflor®) for prevention in the vagina to restore the natural vaginal flora. During pregnancy In the literature it is recommended to consult your doctor or health care professional at a vaginal thrush during pregnancy. Clotrimazole (as gyno Canesten®, Fungotox®) must not be issued for self-medication, according to the summary of pregnant women in the pharmacy. literature Angotti B. , Lambert C. , Soper E. vaginitis: making sense of over-the-counter treatment options. Infect Dis Obstet Gynecol 2007 Pubmed Drug prescribing information (CH)
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eMedicine http://emedicine. medscape. com/article/270872-overview Authors and peer review Authors: PharmaWiki team. Conflicts of interest: None / independent. The authors have no relations with the manufacturers and are not involved in selling the products mentioned. Peer Review: From this article was an internal peer review carried out.