CDC STD Guidelines
VVC usually is caused by C. albicans but occasionally is caused by other Candida sp. or yeasts.
Most common are pruritus and vaginal discharge. Others include vaginal soreness, vulvar burning, dyspareunia, and external dysuria.
1. Yeasts or pseudohyphae on a wet preparation (saline, 10% KOH) of vaginal discharge (pH usually normal at 4.0-4.5);
2. Yeasts or pseudohyphae on Gram stain;
3. A culture or other test yields a positive result for a yeast species.
Fluconazole 150 mg oral tablet, one tablet in single dose.
Multiple OTC and prescription topical prepartions are available.
NOTE: The creams and suppositories in this regimen are oil-based and may weaken latex condoms and diaphragms.
Treatment is not recommended but may be considered in women who have recurrent infection.
Patients should be instructed to return for only if symptoms persist or recur within 2 months of onset of initial symptoms.
Severe VVC: Severe vulvovaginitis (i.e., extensive vulvar erythema, edema, excoriation, and fissure formation) has lower clinical response rates in patients treated with short courses of topical or oral therapy. Either 7--14 days of topical azole or 150 mg of fluconazole in two sequential doses (second dose 72 hours after initial dose) is recommended.
Compromised Host: Women with underlying debilitating medical conditions (e.g., those with uncontrolled diabetes or those receiving corticosteroid treatment) do not respond as well to short-term therapies. Efforts to correct modifiable conditions should be made, and more prolonged (i.e., 7--14 days) conventional antimycotic treatment is necessary.