40 yr female, non diabetic, recurrent vulvo vaginal candidiasis? mix type of vaginitis... also she had sentinel piles. now c/o excess itching with irritating, pain also. please discuss on dx and tx



it's a case of vulvo vaginal candidiasis. patient looks obese. take a smear of vaginal discharge from anterior fornix and look for spores /pseudohyphae after gram stain or saline microscopy. see for risk factors or recurrent v.v candidiasis. r/o hiv.,history of corticosteroids use or frequent antibiotics use. give tab fluconozole 150 MG weekly for 3 -6 months. give micanozole &clotrimazole pessaries for 2 weeks. ketoconazole dusting powder can be used. Anti histamines for pruritis. diclofenac &serratiopeptidase for pain. if you suspect mix type of vaginitis add metronidazole oral 400 mg tid for 5 days. hygiene. weight reduction. if sentinel piles are symptomatic, go for sigmoidoscopy.

Sentinal pile is indicative of chronic fissure and constipation which is another source of faecal contamination of vulva.Rx 1 Tab.cefixime +Ornidazole for 5 days 2.Cap Itraconazole 200mg O.D for 3 weeks 3.Clingen pessary locally. 4.local Clotrimazole dusting powder. 5 . Avoid constipation and use Isapgol.6 Improve local hygiene

Vulvavaginalcandidiasis. Tab. ItrConazole 200mg bid for 2days.followed by tab. Flucanozole 150mg will once. Tab metrogyl 400mg tid tor 4days.gocan dusting powder. Tab levocetrizine for itching.

Candidial infection intertrigo and sattelite lesions,local cotrimazole,/Cicloprox/Amlorofine,use of chlorhexidine soap,systemic antifungal Iatracanzole 200mg 4 weeks,improve hygiene,dusting of clotrimazole powder,keeping the area dry,Minocycline for 5 to 7 days.

r/o hiv, ,dm &std, ,antihistamines, ,antifungal like flukonazole, keto Konazole, ,clingen pessaries to be inserted inside,,genital hygiene should be maintained, ,sup. citralka if burning in urine,,cbc, ,fpbs, ,h.i.v-1,2, ,vdrl and urine (r/m) should be done,

candida albican infection and satellite lesions. local application of antifungal cream and systemic antifungal like Terbenafine 250 mg OD for 3wks.add the same as symptoms persists for 2wks more. .

Inv -vag swab fr cs Urine cs H/o pads using mc change it Ask fr partner inf /do tt him Tab terbitotal single dose orally Local applicants as suggested above Antibiotics according to cs If inf does not give clue do colpo & biopsy if needed Of course ps /pv to exclude int problems

Advised systemic anti fungal.

tab fluconzole 150 mg stat clingen pessary.

clingen pessary (clindamycin and cotrimazole)??

Give, Tab Flucon 150mg weekely for 3-6 months. Tab Cetrizine HS Local hygiene . Tyza dusting powder for local Application.

also treat husband simultaneously. also do Blood sugar, VDRL
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