Prevention and Treatment

25.4 Non-Venereal Genital System Diseases 641

Table 25.4 Vulvovaginal Candidiasis

Symptoms

Itching, burning, thick white vaginal discharge, redness and swelling

Incubation period

Usually unknown. Generally 3 to 10 days when associated with antibacterial medications

Causative agent

Candida albicans, a yeast

Pathogenesis

Inflammatory response to overgrowth of the yeast, which is often present among the normal flora. Associated with antibacterial therapy, use of oral contraceptives, pregnancy, and uncontrolled diabetes, but most cases have no identifiable predisposing factor

Epidemiology

Not contagious. Usually not sexually transmitted.

Prevention and treatment

No proven preventive measures. Intravaginal antifungal medications such as clotrimazole usually effective

interact with other medications or cause rare serious reactions. Simultaneous treatment of any male sex partners is rarely helpful, except when a Candida infection of the penis is present.

The main features of vulvovaginal candidiasis are presented in table 25.4.

Staphylococcal Toxic Shock

Toxic shock syndrome was described in the late 1970s in several children with staphylococcal infections. In 1980, it became epidemic in young healthy menstruating women (figure 25.6) in association with use of a brand of high-absorbency tampon that has since been removed from the market. The term toxic shock syndrome was used to represent the symptoms and signs of their illness, which now that we know the cause, is appropriately called staphylococcal toxic shock. This was not a new disease, but emerged in a new form, and became much more common, as a result of a change in technology and human behavior.

Figure 25.6 Staphylococcal Toxic Shock, United States, 1979-1996 A sharp drop in cases occurred when a brand of high-absorbency tampon was taken off the market. Since 1996 there has been further decline in cases, with non-menstrual cases (men, women, and children) sometimes exceeding the number of cases associated with menstruation (almost all of them tampon users).

Year

*FDA, Food and Drug Administration

Year

*FDA, Food and Drug Administration

Prevention depends on minimizing the use and duration of antibacterial medications, and on effective treatment ofunderlying conditions such as diabetes. Intra-vaginal treatment of C. albicans infections with antifungal medicines such as nystatin or clotrimazole is usually effective. Fluconazole (Diflucan) given by mouth is generally safe and effective although about 1 out of 7 recipients have annoying side effects, and it can

Figure 25.6 Staphylococcal Toxic Shock, United States, 1979-1996 A sharp drop in cases occurred when a brand of high-absorbency tampon was taken off the market. Since 1996 there has been further decline in cases, with non-menstrual cases (men, women, and children) sometimes exceeding the number of cases associated with menstruation (almost all of them tampon users).

642 Chapter 25 Genitourinary Infections

Natural Remedy For Yeast Infections

Natural Remedy For Yeast Infections

If you have ever had to put up with the misery of having a yeast infection, you will undoubtedly know just how much of a ‘bummer’ it is.

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