1. Patients frequently confuse candidiasis with the more common but less notorious bacterial vaginosis. A 2002 study in the Journal of Obstetrics and Gynecology found that only one-third of those women who were self-treating for candidiasis actually had a yeast infection.
2. Many patients are unclear on whether vaginal candidiasis is a sexually transmitted infection. Reassure them that it’s not generally an STI, but a permanent resident of the human body that can proliferate and cause symptoms under certain circumstances, such as high heat and humidity. Patients are often surprised to learn that the same pathogen causes infant diaper rash.
3. Among asymptomatic women, about one in five will show the presence of candida on a high vaginal swab. That doesn’t mean they need treatment.
4. Treating a patient’s partner won’t prevent recurrence of candidiasis, but that’s no reason not to do it.
5. Recurrent candida may be a sign of a compromised immune system. AIDS, cancer treatment or organ transplant can leave the patient vulnerable to yeast infection. Immunocompromised patients are far more likely to develop the dangerous systemic infection candidemia. Other conditions linked to candidiasis are mononucleosis, nutrient deficiency, steroid use, antibiotic use and stress.
6. Vaginal yeast infections typically resolve after a single dose of oral fluconazole. The drug can be taken weekly in the case of recurrent disease. Be aware, however, that candida can develop resistance to the medicines used to treat it.
7. Suppressing ovulation may help, but stick with a progestin-only method, as estrogen may encourage candida’s spread.
8. About one infection in 10 is caused by a species other than Candida albicans. These types are more likely to resist the “-azole” drugs. They may prove more vulnerable to vaginal nystatin.
9. It’s never safe to assume that a vaginal infection is candidiasis, no matter how closely it matches the classic symptoms of pruritis, discharge, etc. Many other conditions can produce similar symptoms, including herpes and dermatitis caused by incontinence.
10. That said, in a patient whose sexual history suggests very low risk for STIs, it’s generally safe to begin treatment for candidiasis without awaiting test results. But early follow-up is vital to ensure it’s working. If it isn’t, reconsider the diagnosis.