Today, thrush is one of the most common problems in gynecology, especially among women of reproductive age. This disease has an infectious nature and is caused by a specific opportunistic fungal flora. The clinical picture in this disease is quite characteristic, and therefore any difficulties in terms of diagnosis are extremely rare. In this article, we will try to understand the causes and methods of treating thrush.

What is thrush and why does it develop?

Thrush, or candidiasis, is a fungal disease caused by opportunistic flora. Most often, with such a pathological process, the vaginal mucosa is affected. However, sometimes specific inflammatory foci can be found on the skin, oral mucosa and even in the intestines. It is worth noting that men can also experience this disease, but much less often.

In this article, we will talk in more detail about the most common form of candidiasis – vaginal. As statistics show, it accounts for about 30-45% of all infectious lesions of the vagina. According to recent reports, up to 75% of women have experienced thrush at least once in their lives. Half of them had repeated episodes of this disease, and in 8%, vaginal candidiasis acquired a recurrent course.

Thrush is most often diagnosed in women of reproductive age. Before the formation of menstrual function and during menopause, this pathology is extremely rare. It is noteworthy that among pregnant women, the prevalence of vaginal candidiasis increases 2-3 times.

First of all, let’s talk about the classification of this disease. It comes in three main forms:

  • Asymptomatic – there are no clinical manifestations;
  • Acute – the duration of the pathological process does not exceed 2 months;
  • Chronic recurrent – the disease lasts more than 2 months.

As we said, thrush is a fungal disease. It is caused by conditionally pathogenic flora belonging to the genus Candida . To date, more than 190 species of such fungi are known, of which more than 27 species live on human mucous membranes. The most common causative agent (in about 80% of cases) is Candida albicans . According to various sources, such fungi are found in 10-17% of non-pregnant women on the mucous membrane of the vagina, in 20-60% of people on the mucous membrane of the oral cavity. However, it should be noted that clinical manifestations are not always present.

One of the most important predisposing factors for the development of candidiasis is a decrease in the level of immune defense. A decrease in immunity, for example, against the background of long-term use of antibacterial drugs, leads to an active reproduction of the fungal flora, followed by the development of an inflammatory reaction. Hormonal imbalances can also contribute to the onset of this disease, which explains its prevalence among pregnant women.  

It is worth noting that in recent years, more and more atypical, treatment-resistant forms of vaginal candidiasis have been diagnosed.

Symptoms of vaginal candidiasis

The severity of symptoms in this pathological process can vary significantly in each case. As we have already said, with asymptomatic carriage, there are no clinical manifestations.

The acute form of thrush is accompanied by rather vivid symptoms. First of all, these include abundant discharge, itching in the genital area. The discharge has a thick cheesy consistency and a grayish-white color. On examination, you can find that the mucous membrane is hyperemic and edematous, there are whitish foci on it, reaching up to several millimeters in diameter. In the acute course of this disease, there is a dense attachment of the plaque to the underlying tissues; when it is removed, eroded surfaces remain . Complaints of severe itching, aggravated in the premenstrual period, are mandatory. 

The clinical picture in the chronic form is not so pronounced. It includes not abundant cheesy discharge, sometimes they are completely absent, moderate redness of the mucous membrane, the appearance of scanty films and dry erosion. 

With a long course of this disease, there is a high risk of spreading the infection to other parts of the genitourinary system. Often, vaginal candidiasis is complicated by secondary damage to the cervix or urethra. During pregnancy, this pathological process can cause its spontaneous interruption.  

Diagnosis of thrush, as a rule, does not cause any difficulties. First of all, it is necessary to conduct an objective examination. Additionally, microscopy of a smear from the genitals is carried out. It is possible to isolate the infectious flora using culture .

This disease is treated with antifungal drugs. In mild cases, local forms of antimycotics are used , and in severe cases, systemic therapy. In parallel, local anti-inflammatory drugs, immunomodulators and vitamins are prescribed.

In 2017, the results of the work of a group of scientists from Irkutsk State Medical University were published. The aim of the study was to determine the efficacy of the azole drug fenticonazole in the local therapy of acute vulvovaginal candidiasis. The patients received fenticonazole 600 mg in a vaginal capsule once, which led to clinical and laboratory recovery on day 4 in 47% of patients with acute uncomplicated candidiasis.

Prevention of vaginal candidiasis

The principles of prevention boil down to the careful use of antibiotics and other immunosuppressive drugs, avoidance of hypothermia, timely correction of hormonal imbalance, and so on.

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