Errors in the diagnosis and treatment of candidal vulvovaginitis were told by obstetrician-gynecologist Karina Bondarenko.
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Common Diagnostic Errors
In 20% of women, Candida fungi are diagnosed through a smear for cytology (PAP test) or microscopy: in the absence of symptoms, treatment is not required. Also, one cannot diagnose candidiasis simply on the basis of a positive result of PCR on Candida with the phrase “detected”, because it is not a fact that vaginal discharge is associated with fungi, and their presence in the biomaterial does not mean that they are involved in inflammation.
Why can not cure thrush
One common cause of treatment failure is only candidiasis treatment. However, in 20-30% of cases other infections, such as bacterial vaginosis or aerobic vaginitis, may also be hidden under its “mask”.
The advertised "natamycin" is not present in any of the developed countries' protocols for the treatment of candidiasis. The first line of therapy should be local or oral drugs from the azole group. Unlike bacterial vaginosis, candidiasis is not associated with a decrease in lactobacilli in the vagina, because probiotics are not suitable for the treatment of thrush. For the treatment of candidiasis, which is repeated more than 4 times a year, two-stage treatment with suppression of exacerbation and long-term anti-relapse treatment with drugs from the azole group up to 6 months should be considered. Treatment with immunomodulators and douching is not only a waste of time, but can also be harmful.
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