Vaginal Candidiasis (moniliasis)

Clinical Description

Common, excessive overgrowth of yeast in the vagina. Infection occurs more frequently in patients taking antibiotics, pregnant women, HIV/AIDS patients and patients with diabetes.

Signs and Symptoms

• Intense vulvo-vaginal itchiness, vaginal and vulval inflammation / redness, thick white rubbery discharge, superficial pain during sexual intercourse or during urination.

Investigations

• High vaginal swab and wet mount microscopy if available.

Pharmacological

Adults

Give Clotrimazole 500mg intravaginal as single dose or Clotrimazole 200mg intravaginal once daily for 3 days OR:

• Give Miconazole 200mg intravaginal once daily for 3 days

OR

• Give Fluconazole 150mg orally as single dose (contra-indicated in pregnancy)

OR

• Give Nystatin Pessary 100,000 IU vaginally 12 hourly for 7 days

To avoid re-infecting her partner, the male partner should:

• Apply the same vaginal cream as the patient Recurrent vulvovaginal candidiasis should be referred to hospital