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Abstract: Candidiasis mostly refers to Candida vaginitis, which has been called vulvovaginal pseudomonal yeast disease, mainly through oral-anal transmission, and can be transmitted to sexual partners through sexual contact, so it is also one of the contagious vaginitis. The patient had the disease repeatedly for one year, causing great inconvenience to her work and life, and her sexual partner also developed candidiasis glans, which was cured after selective medication.
Basic information】Female, 24 years old
Disease Type】Pseudomonas vulvae
Hospital】Guangzhou Huadu District People’s Hospital
Date of Consultation】January 2021
Treatment plan】Medication (vaginal cleansing lotion + pessary + ciprofloxacin hydrochloride tablet + itraconazole capsule)
Treatment period】20 days of treatment
Effectiveness】The disease was cured.
I. Initial consultation
The patient has been suffering from vulvovaginal pseudo-exfoliation yeast disease for 1 year and was treated with miconazole nitrate vaginal soft capsule inserted into the vagina. In the past year, she had recurrent vulvar itching, vaginal tofu-like discharge, and local pain and burning sensation, as well as urinary system infection symptoms such as urinary frequency, urinary urgency, and urinary pain. The patient had no history of hypertension and diabetes mellitus, good general condition, no fever, no abnormal full service on cardiopulmonary auscultation, flat and soft without pressure pain and rebound pain, no palpable liver and spleen on gynecological examination, localized redness and swelling of vulva, broken skin, vaginal patency, large amount of bean curd-like discharge in vagina and attached to vaginal wall, severe congestion and edema of vaginal mucosa, routine laboratory examination of leukorrhea Mycobacterium spores (+), routine urine test leukocytes (++++), preliminary diagnosis of vulvovaginal pseudomycosis.
II. Treatment history
Since the patient had repeated infections for 1 year, vaginal secretions were taken for Candida culture plus drug sensitivity test. Before the results were available, vaginal secretions were completely rinsed with cleansing lotion and white secretions adhering to the vaginal mucosa were cleaned up, and then vaginal suppositories were placed in the vagina for treatment. At the same time as the vaginal medication was started, ciprofloxacin hydrochloride tablets were taken orally for urinary tract infection, while the sexual partner took itraconazole capsules orally. 5 days later bacterial culture plus drug sensitivity test results showed smooth Candida, which was sensitive to itraconazole capsules, therefore, itraconazole capsules were taken orally until the clinical symptoms completely disappeared, and the routine leucorrhoea test was repeated 3 days after stopping the medication, Candida (-), and respectively at the first On the 3rd and 6th day after the first negative routine test of the leucorrhoea, two consecutive routine tests of the leucorrhoea were done and the candida were negative to stop the medication treatment. During the treatment period, we used disposable underwear and replaced all the underwear with new ones after the treatment.
III. Treatment effect
After 20 days of clinical medication, three consecutive routine tests for Candida are negative, which means that the patient has been clinically cured. The patient has no conscious itching and pain in vulva, no urinary frequency, urinary urgency, urinary pain, normal urine routine examination, no redness and swelling in vulva without damage in gynecological examination, not much vaginal discharge, no congestion and edema in milky white vaginal mucosa, all clinical symptoms have disappeared, no positive signs and results in laboratory and clinical examination. Clinical cure is achieved.
IV. Precautions
Pseudomonas vulvae has a very high recurrence rate and can be transmitted to partners through sexual contact or to family members indirectly through clothing contact, so pay attention to washing underwear separately. Avoid wearing underwear that has not been dried in the sun to avoid the growth of Candida, which can cause pseudomonal yeast disease. In case of recurrence, seek medical attention and treat the sexual partner with medication at the same time. In addition, although the disease has been cured, the patient should pay attention to the nature and color of vaginal discharge and whether there is itching in the vulva, and seek medical attention in case of abnormalities.
V. Personal insight
Although vulvovaginal pseudomonal yeast disease is one of the common inflammatory diseases in gynecology, it can cause severe vulvar itching and make the patient restless and sleepless at night, so it needs to be treated actively and thoroughly. Pseudomonal vaginal yeast disease is cured by the standard of 3 routine tests and all Candida negative before stopping the medication, otherwise there is still a possibility of recurrent attacks.