Vaginitis: Monilial

Introduction

• Description: Monilial vaginitis is a vaginal infection caused by ubiquitous fungi found in the air or as common inhabitants of the vagina, rectum, and mouth.

• Prevalence: 25%–40% of “vaginal infections”; 30%–50% of women experience one or more lifetime occurrences; Candida species may be found in the lower genital tract in 10%–25% of healthy, reproductive-aged women.

• Predominant Age: 15–50 years (rare outside this range except for females undergoing estrogen therapy after menopause).

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Candida albicans (80%–95%), C. glabrata, C. tropicalis, or others (5%–20%).

• Risk Factors: Altered vaginal ecosystem (stress, antibiotic use, pregnancy, diabetes, depressed immunity, topical contraceptives, and a warm and moist environment).

Signs and Symptoms

• 15%–25% asymptomatic carrier rate

• Vulvar itching or burning (intense)

• External dysuria, dyspareunia

• Tissue erythema, edema, and excoriations

• Thick, adherent, plaque-like discharge with a white to yellow color (generally odorless)

• Vulvar excoriations

Diagnostic Approach