Candida vulvovaginitis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2], Aravind Kuchkuntla, M.B.B.S [3]

Overview

Candida vulvovaginitis can be classified based on the duration, as well as the strain of Candida causing the infection.

Candida vulvovaginitis can be classified based on the duration of the infection and based on the strain of Candida causing the infection.

Candida vulvovaginitis can be divided based on the duration and number of episodes of the infection into:^[1]^[2]^[3]^[4]

Acute, uncomplicated: these are usually sporadic cases of Candida vulvovaginitis, which respond to topical antifungal therapy and have a high cure rate.
Acute, complicated: symptoms are more severe than uncomplicated infections and typically require a combination of oral and topical anti-fungal treatment.
Recurrent Vulvovaginal Candidiasis (RVVC): defined as 4 or more episodes of Candida vulvovaginitis per year, usually caused by the same strain of Candida. Treatment also requires a combination of oral and topical antifungal agents.
According to 2015, Treatment of STD guidelines - Candida vulvovaginitis can be classified into uncomplicated and complicated based on the following features:^[5]

Uncomplicated Candida Vulvovaginitis	Complicated Candida Vulvovaginitis
Sporadic or infrequent VVC Mild-to-moderate VVC Likely to be Candida albicans Non-immunocompromised women	Recurrent VVC Severe VVC Non-albicans candidiasis Women with diabetes, immunocompromised conditions such as HIV infection), debilitation Immunosuppressive therapy: corticosteroids use

↑ Eckert LO (2006). "Clinical practice. Acute vulvovaginitis". N. Engl. J. Med. 355 (12): 1244–52. doi:10.1056/NEJMcp053720. PMID 16990387.
↑ Sobel JD, Faro S, Force RW, Foxman B, Ledger WJ, Nyirjesy PR, Reed BD, Summers PR (1998). "Vulvovaginal candidiasis: epidemiologic, diagnostic, and therapeutic considerations". Am. J. Obstet. Gynecol. 178 (2): 203–11. PMID 9500475.
↑ Sobel JD (2007). "Vulvovaginal candidosis". Lancet. 369 (9577): 1961–71. doi:10.1016/S0140-6736(07)60917-9. PMID 17560449.
↑ Vazquez JA, Sobel JD, Demitriou R, Vaishampayan J, Lynch M, Zervos MJ (1994). "Karyotyping of Candida albicans isolates obtained longitudinally in women with recurrent vulvovaginal candidiasis". J. Infect. Dis. 170 (6): 1566–9. PMID 7995997.
↑ Workowski KA (2015). "Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines". Clin Infect Dis. 61 Suppl 8: S759–62. doi:10.1093/cid/civ771. PMID 26602614.