*!* Recurrent vaginal candidiasis......... - pindi

[ArchivalUser]

A 30-year-old woman is evaluated for a 3-day history of vaginal discharge, itching, and irritation. During the past 12 months, she has had five similar episodes and has treated her symptoms successfully with an over-the-counter vaginal yeast cream. Three months ago, a fasting plasma glucose measurement was normal. She is monogamous and has had one male partner for the past 6 months. Vaginal examination during an office visit reveals inflammation of the external genitalia and a nonodorous vaginal discharge adherent to the vaginal walls. Upon microscopic examination of the vaginal discharge with potassium hydroxide slide preparation, pseudohyphae and budding filaments are noted. A pregnancy test is negative. She would like to discuss what she can do to prevent recurrences.

Which of the following is the most appropriate next step in management?

A Ingest lactobacillus cultures daily
B Begin weekly douching
C Avoid simple sugars
D Treat partner with antifungal cream
E Begin weekly oral fluconazole

[ArchivalUser]

dd

[ArchivalUser]

EEE

[ArchivalUser]

yes....E...is correct.


A trial involving weekly fluconazole treatment may benefit this patient, who is experiencing recurrent vaginal yeast infections.

In a recent study, 373 women with at least four documented episodes of yeast vaginitis during the previous year were treated with fluconazole, 150 mg weekly for 6 months, or placebo. At 6 months, more patients in the treatment group (90.8%) were free of recurrent yeast vaginitis than those in the placebo group (35.9%).

During a 6-month observation period following treatment, fewer treatment and placebo patients were recurrence free (21.9% and 42.9%, respectively).

Although this therapy did not result in a long-term cure of yeast vaginitis, it was an effective short-term treatment.