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Home Gynecology and Obstetrics

Monilial vaginitis (Vaginal candidiasis)

Dr.Galal Baligh by Dr.Galal Baligh
June 21, 2019
in Gynecology and Obstetrics
679 29
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Monilial vaginitis

Monilial vaginitis

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1 Monilial vaginitis (Vaginal candidiasis) incidence:
2 Monilial vaginitis (Vaginal candidiasis) aetiology:
3 Monilial vaginitis (Vaginal candidiasis) diagnosis:
4 Monilial vaginitis (Vaginal candidiasis) investigations:
5 Monilial vaginitis (Vaginal candidiasis) treatment:
6 Recurrent moniliasis
6.1 Recurrent moniliasis definition:
6.2 Recurrent moniliasis aetiology:
6.3 Recurrent moniliasis investigations:
6.4 Recurrent moniliasis treatment:
7 Monilial vaginitis (Vaginal candidiasis) PPT(power point presentations):
7.1 Vulvovaginal candidiasis ( Monilial vaginitis )ABOUBAKR ELNASHAR BENHA UNIVERSITY HOSPITAL, EGYPT PPT
7.2 Vulvovaginal Infections Review Dr Muhammad El Hennawy Ob/gyn Consultant Rass el barr central hospital Dumyatt PPT

Monilial vaginitis (Vaginal candidiasis) incidence:

* Represent 30% of causes of vaginitis (The 2nd most common).
* Present in 20% of pregnant women.

Monilial vaginitis (Vaginal candidiasis) aetiology:

♦♦♦ Causative organism:
* Candida albicans (90% of cases): (With pseudohyphae & reproduce by budding).
* Others: candida tropicalis, Glabrata, and Krusei.
♦♦♦ Rout of infection:
* Sexual route: from diabetic partner i.e. diabetic balanitis.
* Non-sexual routes:
– Exacerbation of a carrier state.
– Infected towels & toilet seats.
– Infection from intestinal candidiasis.
♦♦♦ Predisposing factors:
* These factors share high vaginal acidity, rich carbohydrates & lowered immunity.
– Pregnancy & high dose COCS.
– DM & immunosuppressive states.
– Prolonged antibiotic therapy & prolonged corticosteroid therapy.
– Excess humidity.

Monilial vaginitis
Monilial vaginitis (Vaginal candidiasis)

Monilial vaginitis (Vaginal candidiasis) diagnosis:

* Rare in child and old age (estrogen dependent infection).
* Most cases are premenstrual (high acidic medium)
♦♦♦ Symptoms:
– Pruritus vulvae: main complaint & not related to amount of discharge.
– Discharge: * white, curdy, thick, and scanty,
* Odorless (may be yeasty), or offensive in mixed infection.
– Pain & soreness of vulva: secondary vulvitis.
– Dyspareunia: due to tender vagina.
– Frequency & burning micturition.
♦♦♦ Signs:
– Vulva: Red & tender with scratching marks.
– Vagina: White patches adherent to the vaginal wall.

Monilial vaginitis (Vaginal candidiasis) investigations:

♦♦♦ Diagnosis of the disease:
– Fresh drop examination (wet film):
* Drop of discharge is mixed with drop of saline on a slide & examined: shows no movement.
* KOH can be used to kill all cells except candida.
– Stained film:
* Methylene blue: to see the organism.
* Gram stain: Gram +ve & violet.
– Culture: on Nickerson’s medium.
– PH: 3.5 – 4.5 (> 4.5 excludes candida).
♦♦♦ For predisposing factors: blood glucose for DM.

Monilial vaginitis (Vaginal candidiasis) treatment:

♦♦♦ General measures:
– Control predisposing factors e.g. DM.
– Vitamin B complex: ↓growth of monilia.
– Local hygiene; shaving hair, keep dry, change clothes.
– Cotton made underwear and should be boiled.
– Vaginal douches alkaline e.g. NaHCO3 or antiseptic povidone iodine.
♦♦♦ Local :
* Imidazole derivatives (given for 5 days).
– Miconazole: gynodactrin cream.
– Tioconazole: gynotrosyd vaginal pessary.
– Clotrimazole: canesten vaginal pessary & cream.
* Nystatin:
– Mycostatin vaginal pessary & cream.
– Twice daily for 2 weeks, then
– Once daily for another 2 weeks.
♦♦♦ Systemic treatment:
* Imidazole derivatives:
– Ketoconazole: 200 mg bid for 5 days.
– Fluconazole: 150 mg single dose.
– Itraconazole.
* Nystatin:
– Mycostatin: 100o, 000 units’ tid for 7 days in cases of intestinal candidiasis.

Recurrent moniliasis

Recurrent moniliasis definition:

Four attacks or more of monilial infections in one year.

Recurrent moniliasis aetiology:

* Prolonged antibiotic therapy is the main cause.
* Persistent source of infection e.g. – Intestinal candidiasis,
– Organism under nails.
* Persistent source of infection e.g. – Infected sexual partner.
* Persistent predisposing factors e.g. – Uncontrolled D.M.

Recurrent moniliasis investigations:

* Culture is mandatory to detect non-albicans species & HPV.

Recurrent moniliasis treatment:

* Correction of predisposing factors.
* Long oral low dose course of Imidazole derivative;
– e.g. Fluconazole 50 mg once weekly for 3-6 months.

Monilial vaginitis (Vaginal candidiasis) PPT(power point presentations):

Vulvovaginal candidiasis ( Monilial vaginitis )ABOUBAKR ELNASHAR BENHA UNIVERSITY HOSPITAL, EGYPT PPT


Vulvovaginal Infections Review Dr Muhammad El Hennawy Ob/gyn Consultant Rass el barr central hospital Dumyatt PPT


Tags: Monilial vaginitismoniliasisPruritus vulvaeVaginal candidiasisVulvovaginal Infections
Dr.Galal Baligh

Dr.Galal Baligh

OB-GYN Specialist

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