Candidasis and other synonyms to it Organism and mode of infection Predisposing factors Diagnosis Precautions while taking vaginal swab Treatment Nursing care

1. Candidasis (monilia vaginitis)

2. Also referred toit as
vulvovaginal
candidasis (VVC) ,
candidal vaginitis ,
monilial infection or
vaginal yeast
infection.

3. Organism: Fungus ( yeast )
Mode of infection: Auto-infection
vagina naturally contains a balanced mix of yeast, including
candida, and bacteria. Certain bacteria (lactobacillus) act to
prevent an overgrowth of yeast but that balance can be disrupted.
An overgrowth of candida or penetration of the fungus into
deeper vaginal cell layers causes the signs and symptoms of a
yeast infection.
Organism & Mode
of infection

4. Predisposing
factors
Antibiotic use
Yeast infections are common in women who take antibiotics. Broad-
spectrum antibiotics, which kill a range of bacteria, also kill healthy bacteria
in vagina, leading to overgrowth of yeast.
Increased estrogen levels
Yeast infections are more common in women with higher estrogen levels —
such as pregnant women or women taking high-dose estrogen birth control
pills or estrogen hormone therapy.
Uncontrolled diabetes
Women with poorly controlled blood sugar are at greater risk of yeast
infections than women with well-controlled blood sugar.
Impaired immune system
Women with lowered immunity — such as from corticosteroid therapy or
HIV infection — are more likely to get yeast infections.

5. Diagnosis
Signs and symptoms
• Abnormal vaginal discharge (Thick, white, odor-free vaginal discharge
with a cottage cheese appearance).
• Vaginal itching or soreness.
• Pain during sexual intercourse.
• Pain or discomfort During urination.
• Vaginal itching or soreness.
• Some women can develop severe infections involving redness, swelling,
and cracks in the wall of the vagina.

6. Diagnosis,
cont..
Lab investigations
• Vaginal swab: Normal vaginal pH is 3.8 to 4.5, Vaginal pH above 4.5 is less
acidic, making it easy for bacteria and yeast to thrive.
• Blood culture test.
• Microscopic examination of a vaginal discharge sample.
• Culture test: this is done by introducing cells from a vaginal swab into a sterile
medium to see if yeast will grow. Results are usually available within a few days.
• KOH slide : a sample of the vaginal discharge is placed on a slide and mixed with
a solution of 10% KOH. The KOH kills bacteria, leaving only yeast.

7. Precautions
of vaginal
swab
- Avoid sexual intercourse before the test.
- Avoid making this test during Menstruation.
- Stop antibiotics for 72 hours before taking swab.
- Avoid using tampons & douching 24 hours before taking swab.
- Can take the sample at any time of the day.
- Wash hands using soap and warm water and dry it.
- Open the swab packet at the blue end
- Remove the swab container from the packet and label the
container with name, date of birth and the date and time the sample
is being taken.
- Send the sample immediate after taken
- Vaginal swab specimens must be transported to laboratory at 2 C
to 30 C and tested within 60 days of collection.
- If longer storage is needed, freeze at -20 C to -70 C for up to 12
months after collection.

8. Precautions
of vaginal
swab

9. Treatment
Candida infections are treated with antifungal medications such as :-
• nystatin
• Clotrimazole
• amphotericin B
• miconazole
Mild or moderate genital Candida infections can have treatment with antifungal
vaginal cream.
The antifungal creams come in 1or7-day treatment.
Econazole or fluconazole 150 mg orally one-time dose can also be prescribed.
Clinicians should avoid prescribing fluconazole in the first trimester of pregnancy.
For recurrent vaginal candida infections, fluconazole dosing is on days 1 or 7 and
then weekly for six months is given.

10. Nursing
Care
Assessment
Assess typical symptoms which can worsen just before menses, include:-
• Pruritus.
• Vaginal discharge (thick, white, curd-like).
• Vaginal soreness.
• Vulvar burning.
• Erythema in the vulvovaginal area.
Intervention
• Monitor intake and output as Dysuria often occurs as a result of local irritation
of the urinary meatus.
• Monitor lab tests.

11. Health
teaching
• Increase nutrition rich in vitamin C and yogurt.
• Wear white, 100% cotton clothes.
• Avoid wearing tight cloths.
• Shower rather than taking tub baths.
• Wash clothes in unscented laundry detergent and hot water and dry in a
hot dryer to kill the yeast that clings to the fabric.
• Practice good body hygiene.
• Avoid vaginal sprays.
• Use white, unscented toilet paper and wipe from front to back.
• Avoid use of antibiotics without the doctor order.
• Keep the perineal area dry & clean with worm water only.
• Use pad to absorption of vaginal discharge.
• reduce dietary intake of simple carbohydrates & sugars