Candida Species
Introduction Introduction ulvovaginal candidiasis (VVC) is a disease caused by V the abnormal growth of yeast-like fungi on the mucosa of the female genital tract (Souza et al., 2009). Although Candida species occur as normal vaginal flora, opportunistic conditions such as diabetes, pregnancy and other immune depressants in the host enable them to proliferate and cause infection (Pam et al., 2012). There are approximately 200 Candida species, among which are Candida albicans, glabrata, tropicalis, stellatoidea, parapsilosis, catemilata, ciferri, guilliermondii, haemulonii, kefyr and krusei. Candida albicans is the most common species (Pam et al., 2012). The most frequent cause of VVC is Candida albicans. Non-Candida albicans species of Candida, predominantly Candida glabrata, are responsible for the remainder of cases (Ge et al., 2010). It is estimated that 75% of women experience at least one episode of vulvovaginal candidiasis throughout their life and 40-50% of them have at least one recurrence (González et al., 2011). Most patients with symptomatic VVC may be readily diagnosed on the basis of microscopic examination of vaginal 1 Introduction secretions. Culture is a more sensitive method of diagnosis than vaginal smears, especially in a suspected patient with a negative result for microscopy (Khosravi et al., 2011). Antifungal agents that are used for treatment of VVC include imidazole antifungals (e.g., butoconazole, clotrimazole, and miconazole), triazole antifungals (eg, fluconazole, terconazole), and polyene antifungals (e.g., nystatin) (Abdelmonem et al., 2012). The azoles, particularly fluconazole, remain among the most common antifungal drugs used for prophylaxis and treatment (Pietrella et al., 2011). It is recommended in various guidelines as the first drug of choice because it is less toxic and can be taken as a single oral dose (Pam et al., 2012).
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