Candidal vulvovaginitis is a relatively common infection affecting women. It can be classified as uncomplicated or complicated based on clinical features, with about 90% of infections being uncomplicated. The classification can help guide the type and course of therapy used to treat the condition.
Uncomplicated - all of the following:
(1) mild or moderate in severity
(2) sporadic
(3) due to Candida albicans
(4) host normal
Complicated - one or more of the following:
(1) severe
(2) recurrent
(3) due to a species other than Candida albicans (may be azole resistant)
(4) host abnormal
Abnormal hosts:
(1) uncontrolled diabetes mellitus
(2) neutropenia
(3) immunosuppression
(4) pregnancy
(5) broad-spectrum antibiotic use
Interpretation:
• A patient with uncomplicated disease is fairly easy to treat. Patients respond to short-term courses of oral or topical antifungal agents.
• A patient with complicated disease may require more aggressive therapy lasting 7 days or more. In addition, the patient should be evaluated for candidal infections at other sites.
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