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Yeast infection for years: The request could not be satisfied

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Chronic Yeast Infections : Common Causes

While 75% of women will get at least one yeast infection in their lifetime, up to 8% get more than four a year. They’re called recurrent yeast infections when they happen over and over.

If you’re one of those women, you and your doctor might need to take a different approach.

What Could Be Happening

Most yeast infections are caused by a type of fungus (candida) called Candida albicans. Other kinds of fungus can cause yeast infections, too, but antifungal treatments usually only target the most common one. If your infection is caused by something different, antifungals used to treat yeast infections may not be effective for you.

Or, while it may seem as though you’re getting new infections, you may not have gotten rid of the first one. Be sure to follow your treatment instructions carefully and finish all of your medicine.

Using antibiotics too often can lower the amount of good bacteria in your vagina. This can allow candida to grow and raise your chances of a yeast infection. The longer you use antibiotics, the more likely you are to get one.

High blood sugar from uncontrolled diabetes makes it easier for yeast to feed and thrive.

Hormonal birth control, including oral contraceptive pills and spermicidal creams and jellies, may alter the balance of bacteria in your vagina, allowing more candida to grow.

Wearing wet or tight clothing, like sweaty gym clothes that you don’t change out of right away, or a damp bathing suit after a swim, creates a warm, damp place that yeast likes.

Eating Habits

While some people believe certain foods or diets promote the growth of yeast and lead to recurrent infections, there’s not enough research to support that theory.

According to the studies that have been done, a strict diet doesn’t seem to be helpful in terms of preventing them.

Talk With Your Doctor

Your doctor can help you figure out what’s going on, especially if it’s a different kind of infection or a medical condition that’s causing your symptoms. An accurate diagnosis is the best way to get the right treatment and find relief.

Chronic Vulvovaginal Candidiasis – American Family Physician

PAUL NYIRJESY, M.D., Jefferson Medical College, Philadelphia, Pennsylvania

Am Fam Physician. 2001 Feb 15;63(4):697-703.

Frequently ignored by the medical community, chronic vulvovaginal symptoms are relatively common and can be frustrating for patients and physicians. Establishing a proper diagnosis will lay the foundation for an effective therapeutic plan. Fungal cultures are an important component of the work-up. The most common causes of chronic vaginal symptoms are recurrent vulvovaginal candidiasis (RVVC), vulvar vestibulitis syndrome and irritant dermatitis. In patients with RVVC caused by Candida albicans, host factors may play an important role. Long-term oral antifungal therapy will break the pattern of recurrence in many patients. Infections caused by other species of yeast may be more resistant to standard treatment approaches.

For any physician involved in the health care of women, the treatment of vaginitis remains a challenge. Vaginitis accounts for more than an estimated 10 million physician office visits annually, and it remains the most common reason for patient visits to obstetrician-gynecologists.1

Over-the-counter (OTC) antifungal therapies now rank among the top 10 best-selling OTC products in the United States with an estimated $250 million in sales annually. Given that millions of women contract vaginitis, it is not surprising that a subpopulation of women with chronic vaginitis (defined here as some type of chronic vulvar or vaginal symptom lasting more than six months) exists. In the past few decades, centers devoted to evaluating and treating women with chronic vaginitis have been established at various academic medical centers. In conjunction with the establishment of these centers, studies of chronic vaginitis have been undertaken and new approaches to the problem have been investigated. The purpose of this article is to summarize the current concepts in the evaluation of women with chronic vulvovaginal symptoms and to discuss recurrent vulvovaginal candidiasis (RVVC) in detail.

Establishing a Diagnosis

Despite the extensive use of medications to treat vaginal symptoms, the appropriateness of their use is undermined by an attitude that deems an accurate diagnosis unnecessary. Women are encouraged to self-medicate, and women with chronic vaginal symptoms often do. In one survey2 of 105 women with chronic vaginal symptoms, 73 percent self-treated with OTC products and 42 percent used alternative medicines. Most of these women thought they had RVVC but, when they were evaluated at a specialty referral center, only 28 percent were diagnosed with RVVC. They were, therefore, using these medications inappropriately and, in at least the 15 percent of women in the study who had irritant dermatitis, their self-treatment played a role in the perpetuation of their symptoms.

Estimates of how accurately women are able to self-diagnose RVVC are difficult to obtain. Initial data3 suggested that women with a prior diagnosis of vulvovaginal candidiasis were able to make an accurate diagnosis up to 82 percent of the time based on symptoms alone. However, this number may represent an overestimate because patients in this study had been initially screened by telephone and were only evaluated and included in the study if they had symptoms consistent with vulvovaginal candidiasis. A recent questionnaire study4 of 634 women found that only 11 percent were able to accurately recognize the classic case scenario for yeast infections. Women who had a previous diagnosis of vulvovaginal candidiasis were also inaccurate in their self-diagnosis, but they were more likely to self-treat. Finally, it should be noted that, even with a strict telephone triage protocol, diagnosis by telephone is only marginally better then random chance.5

When considering the results of these studies, it is apparent that the best chance for making an accurate diagnosis remains with the clinician. Table 1 lists differential diagnoses with the pertinent features of the histories and physical examinations. Particularly in women with chronic vaginitis, timely evaluation during acute exacerbations when the patient is not using any treatment regimen can yield valuable insights into the cause of the symptoms. When taking the medical history, it is important to understand that the symptoms related to vaginitis include a broad spectrum of manifestations, which go well beyond changes in the vaginal discharge. A thorough history should include questions about the nature, quantity and color of the discharge, as well as about irritation, itching, burning and dyspareunia.

View/Print Table

TABLE 1

Most Common Diagnoses Encountered at a Vaginitis Referral Center
Diagnosis Symptoms Findings Treatment/comments

Recurrent vulvovaginal candidiasis

Itching Irritation Burning Dyspareunia Abnormal discharge

Erythema of vulva and/or vagina Swelling of labia minora Vaginal thrush Normal pH Hyphae/blastospores on microscopy Positive fungal culture

Treatment depends on species of infecting organism; see text for full discussion.

Irritant dermatitis

Irritation Burning

Erythema of vulva and/or vestibule Normal pH Negative microscopy Negative fungal culture

Removal of potential irritants Topical corticosteroid ointment

Vulvar vestibulitis

Often minor irritation or burning in day-to-day activities Acquired dyspareunia with intromission Pain with other contact with introitus (e.g., tampon insertion)

Areas of focal vestibular erythema Tenderness with palpation of erythematous areas Normal pH Normal microscopy Negative fungal cultural

Removal of potential irritants Topical 4% lidocaine prior to coitus Low-potency topical corticosteroid ointment Low-dose tricyclic antidepressant therapy Pelvic floor biofeedback therapy Low oxalate diet with calcium citrate pills Vestibulectomy with vaginal advancement

Bacterial vaginosis

Chronic gray discharge Fishy odor Mild irritation or itching

Gray or yellow discharge ≥pH 4. 5 Positive amine test Epithelial cells with more than 20% clue cells

Oral metronidazole (Flagyl), 500 mg twice daily for seven days Topical metronidazole gel 0.75%, at bedtime for five days Topical clindamycin 2% vaginal cream (Cleocin Vaginal) at bedtime for three days No clear consensus on management of patient with recurrent infection; treating partner not shown to be effective.

Physiologic discharge

Chronic white discharge, unchanged with past therapies Mild acid odor

Flocculent or thick white discharge Normal pH Normal microscopy Negative fungal culture

None

TABLE 1

Most Common Diagnoses Encountered at a Vaginitis Referral Center
Diagnosis Symptoms Findings Treatment/comments

Recurrent vulvovaginal candidiasis

Itching Irritation Burning Dyspareunia Abnormal discharge

Erythema of vulva and/or vagina Swelling of labia minora Vaginal thrush Normal pH Hyphae/blastospores on microscopy Positive fungal culture

Treatment depends on species of infecting organism; see text for full discussion.

Irritant dermatitis

Irritation Burning

Erythema of vulva and/or vestibule Normal pH Negative microscopy Negative fungal culture

Removal of potential irritants Topical corticosteroid ointment

Vulvar vestibulitis

Often minor irritation or burning in day-to-day activities Acquired dyspareunia with intromission Pain with other contact with introitus (e.g., tampon insertion)

Areas of focal vestibular erythema Tenderness with palpation of erythematous areas Normal pH Normal microscopy Negative fungal cultural

Removal of potential irritants Topical 4% lidocaine prior to coitus Low-potency topical corticosteroid ointment Low-dose tricyclic antidepressant therapy Pelvic floor biofeedback therapy Low oxalate diet with calcium citrate pills Vestibulectomy with vaginal advancement

Bacterial vaginosis

Chronic gray discharge Fishy odor Mild irritation or itching

Gray or yellow discharge ≥pH 4. 5 Positive amine test Epithelial cells with more than 20% clue cells

Oral metronidazole (Flagyl), 500 mg twice daily for seven days Topical metronidazole gel 0.75%, at bedtime for five days Topical clindamycin 2% vaginal cream (Cleocin Vaginal) at bedtime for three days No clear consensus on management of patient with recurrent infection; treating partner not shown to be effective.

Physiologic discharge

Chronic white discharge, unchanged with past therapies Mild acid odor

Flocculent or thick white discharge Normal pH Normal microscopy Negative fungal culture

None

Further questions about the primary location of symptoms (vulva, introitus or deep vaginal), variation of symptoms with the menstrual cycle, attempts at self-treatment and response to prior therapies will further clarify the clinical history. Finally, information should be obtained about whether the patient is sexually active, whether she experiences dyspareunia, the number of past and present sex partners, the extent and types of sexual activity and the age at which she first became sexually active.

The physical examination should begin with an inspection of the vulva, looking for areas of erythema, edema, ulceration or chronic vulvar skin changes, combined with palpation using a cotton-tip applicator to elicit areas of tenderness. After insertion of the speculum, the vagina and cervix should be inspected thoroughly and specimens obtained from the lateral vaginal wall for laboratory evaluation. These evaluations should include a vaginal pH, the amine (whiff) test, saline and 10 percent potassium hydroxide (KOH) smears for microscopic examination, and fungal cultures. A normal pH (less than 4.5) effectively rules out bacterial vaginosis, whereas a pH greater than 4.5 has a limited differential diagnosis (Table 2). A whiff test for the presence of amines should be performed by placing a drop of 10 percent KOH onto the vaginal secretions and checking for a fishy odor. Saline microscopy permits identification of trichomonads and clue cells, as well as other additional information.

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TABLE 2

Potential Causes for Elevated Vaginal pH

Physiologic causes

Menses

Heavy cervical mucus (i.e., ovulation)

Recent intercourse with semen in vagina

Pregnancy with rupture of membranes

Hypoestrogenism

Infectious causes

Trichomoniasis

Bacterial vaginosis

Foreign body with secondary infection

Streptococcal vaginitis (group A) (rare)

Desquamative inflammatory vaginitis (rare)

TABLE 2

Potential Causes for Elevated Vaginal pH

Physiologic causes

Menses

Heavy cervical mucus (i. e., ovulation)

Recent intercourse with semen in vagina

Pregnancy with rupture of membranes

Hypoestrogenism

Infectious causes

Trichomoniasis

Bacterial vaginosis

Foreign body with secondary infection

Streptococcal vaginitis (group A) (rare)

Desquamative inflammatory vaginitis (rare)

In patients with thinning of the vagina from a lack of estrogen or from infection, parabasal cells may be present. These cells are smaller and more oval with a relatively large nucleus compared with normal vaginal superficial cells. Although white blood cells can be present in normal secretions, a ratio of white blood cells to epithelial cells of more than 1:1 suggests an underlying infection. An assessment of bacterial flora (lactobacillus-dominant or not) can be helpful in determining whether a patient has bacterial vaginosis. By adding 10 percent KOH to the slide, the epithelial cells undergo lysis, which increases the ability to identify hyphae or blastospores (Figure 1)

View/Print Figure

Blastospores, hyphae and pseudohyphae in a case of vulvovaginal candidiasis.

FIGURE 1.

Blastospores, hyphae and pseudohyphae in a case of vulvovaginal candidiasis.

FIGURE 1.

In the general population, approximately 15 to 20 percent of women are asymptomatically colonized with yeast.6 Routine fungal cultures will, therefore, frequently identify women harboring yeast species as part of their flora but who do not require therapy. However, in women with chronic vaginal symptoms, fungal cultures performed on a routine basis are helpful because they corroborate a diagnosis of RVVC, permit identification of the infecting species and increase the 50 percent sensitivity of the 10 percent KOH preparation. In this patient population, successful treatment of a positive fungal culture, corroborated by a negative follow-up culture results in resolution of symptoms approximately 90 percent of the time.7

Some patients may need additional studies. In patients with vulvar or vaginal ulcerations, herpes cultures are indicated. If chronic skin changes occur or ulcers exist, a vulvar biopsy may help identify lichen sclerosus, squamous epithelial hyperplasia, other vulvar dermatoses, or even cancer and its precursors. Cultures for trichomoniasis, gonorrhea and chlamydia are indicated if the secretions reveal many white blood cells but no underlying cause is found.

Using this diagnostic approach, the majority of women with chronic vaginitis can be accurately diagnosed. Table 1 lists the most common diagnoses in women seen at a vaginitis referral center, along with appropriate treatments.2 RVVC remains the most common problem encountered in such centers, although the proportion of women with this condition (28 percent) is smaller than might be expected. Furthermore, the two other most common vaginitides, bacterial vaginosis and trichomoniasis, occur less often than might be expected in this referral population. Patients diagnosed with simple physiologic discharge (7 percent) were seen almost as often as patients diagnosed with bacterial vaginosis (11 percent). Metronidazole-resistant trichomoniasis was diagnosed in fewer than 1 percent of patients. The preponderance of patients who present with chronic vulvar disorders emphasizes the need to broaden the differential diagnosis when evaluating women with suspected chronic vaginitis.

Recurrent Vulvovaginal Candidiasis

Vulvovaginal candidiasis is a common condition. An estimated 75 percent of all women will develop a yeast infection during their lifetime; 90 percent of these infections are caused by Candida albicans. Further estimates indicate that 5 percent of women with vulvovaginal candidiasis may develop RVVC, which is defined as four or more episodes of vulvovaginal candidiasis in the previous year.6 Species such as Candida glabrata, Candida parapsilosis and Saccharomyces cerevisiae are responsible for up to 33 percent of recurrent infections.7 As will be discussed later, there may be inherent differences between C. albicans and non–C. albicans infections; therefore, obtaining a positive fungal culture, which includes identifying the infecting organism, is an essential first step in the management of RVVC.

Three primary theories have been proposed to explain why some women develop RVVC. The intestinal reservoir theory suggests that the recurrences are a result of persistence of the organism in the gastrointestinal tract and later reinfection of the vagina. This theory is based on uncontrolled data8 from the late 1970s in which a concordance of almost 100 percent was observed between rectal and vaginal cultures in women with RVVC. However, subsequent studies9 suggest that women with RVVC harbor yeast species in the gastrointestinal tract as often as control subjects. Furthermore, in women who experienced a recurrence after taking prolonged courses of systemic ketoconazole for RVVC and who experienced a recurrence following cessation of therapy, the recurrence often occurred in the presence of negative rectal cultures for yeast.10 The results from these two studies make it less likely that the intestinal reservoir theory satisfactorily explains the cause of RVVC.

The sexual transmission theory views the partner as the source of the reinfection. Indeed, at least 20 percent of the partners of women with RVVC harbor the same yeast species in their mouth, fingers or genital area.10 However, in the majority of cases, the partner is culture-negative and cannot be implicated as the source of reinfection. Furthermore, at least one longitudinal study11 of couples in which the woman had RVVC indicates that the higher colonization rate in the man is more a reflection of his exposure to the chronically infected woman than an indication that the transmission occurred in the other direction. On a practical level, treatment of the partner seems to have no effect on the woman’s risk of recurrence12 and is not recommended by most experts.6

The vaginal relapse theory maintains that, even after treatment, some women remain colonized with small numbers of yeast. Given the proper conditions, the yeast increase in number and cause a new clinical episode of vulvovaginal candidiasis. Support for this theory includes longitudinal studies13 that document persistence of the same strain of C. albicans causing repeated infections in the same women over several years of observation and after repeated treatment courses. According to this view, repeated episodes are not the result of reinfections, but rather caused by host factors. Although obvious exogenous factors such as diabetes, use of antibiotics and systemic corticosteroids, and infection with human immunodeficiency virus may play a role in RVVC, no obvious explanation exists for most recurrences. Much research is currently focused on possible abnormalities of the local vaginal immune response to yeast and their role in laying the groundwork for the patient’s next infection. 14

When treating women with RVVC, controlling any underlying medical conditions may be helpful. Although dietary changes (i.e., a yeast-free diet) have been frequently advocated as a treatment for RVVC, no studies have documented any efficacy to this approach. When the infection is caused by C. albicans, RVVC is best managed using an initial 14-day course of oral azole therapy to induce clinical remission and a negative fungal culture, followed by a six-month maintenance regimen.6 Maintenance regimens include ketoconazole (Nizoral), 100 mg daily; itraconazole (Sporanox), 100 mg daily; and fluconazole (Diflucan), 100 to 200 mg weekly.

An alternative topical maintenance regimen consists of clotrimazole vaginal suppositories (Gyne-Lotrimin), 500 mg weekly. An examination and reculture of the patient after the initial two-week regimen and then at the three- and six-month points in the maintenance regimen will ensure that the antimycotic therapy is effective and that the patient’s symptoms have resolved. While on maintenance therapy, at least 90 percent of patients will not experience a recurrence. Furthermore, particularly with oral regimens, at least some of the protective effects persist after discontinuation of therapy.15 Treatment should be individualized for patients who experience a recurrence following completion of a maintenance regimen, but the option of restarting a maintenance regimen if the recurrences become frequent should be considered.

In cases of RVVC secondary to C. albicans, resistance to antifungal therapy seems rare in that the vast majority of patients will, at a minimum, do well while on antifungal maintenance regimens. However, for infections caused by non–C. albicans species, particularly those due to C. glabrata, clinically evident resistance seems more common.7,16 In patients who failed standard azole therapy, boric acid vaginal suppositories (600 mg daily for 14 days)16 and topical flucytosine (Ancobon) cream have been used successfully.17 Treating patients who continue to have symptoms while on therapy or who experience a recurrence shortly after completing therapy is a particularly difficult problem. Information about the treatment of these patients remains limited to anecdotal and unpublished data. However, using combination therapy and extending the duration of treatment seem to be logical approaches to this difficult clinical scenario, particularly if frequent reculturing is performed to assess the mycologic response.

Final Comment

Chronic vulvovaginal symptoms are relatively common and may be difficult for both the patient and the physician. However, by placing an emphasis on obtaining an accurate diagnosis, the cause of the patient’s symptoms can often be determined. In women who fail to respond to treatment, it is important to reestablish the diagnosis to make sure that the cause of the symptoms remains the same.

How to Avoid Frequent Yeast Infections

Yeast infections are not only annoying, they are very common. Three out of four women will have a yeast infection at some point in their lives, and most women experience at least two infections. Those with recurrent infections may experience as many as four or more a year.

“Most yeast infections are easily treated. However, for some women, recurrent problems require a more specialized plan of care. In these cases, itching can become so severe that it causes swelling and sores. We’ve been very successful at treating these chronic infections and helping women avoid them,” said Dr. Anne Martinelli.

What causes a yeast infection (vaginal candidiasis)?

A healthy vagina contains a combination of yeast and bacteria, referred to as vaginal flora. The bacteria help form a perfect balance by preventing the overgrowth of yeast. If for any reason this equilibrium is disrupted, it can cause a yeast infection.

There are several possible causes of a yeast infection, but most are caused by a specific type of fungus called candida albicans. (Mayo Clinic). 

In addition, there are situations that put you at greater risk for developing a yeast infection. These include:

  • Using antibiotics (these contribute to the imbalance between yeast and bacteria)
  • Having a compromised immune system
  • Failing to control diabetes
  • Increasing estrogen levels, which may be caused by oral contraceptives or hormone therapy
  • Being pregnant.

While infections caused by candida albicans are common and generally easy to treat, recurring infections are sometimes caused by a less common fungus, which means we’ll need to provide a more specialized, long-term treatment.

What are the symptoms of a yeast infection?

The main symptom of a yeast infection is an intense itching and irritation around the vulva and vaginal areas. Other symptoms include:

  • Burning pain during intercourse
  • A red and swollen vulva
  • Stinging or burning while urinating
  • A vaginal rash
  • Smelly discharge
  • Vaginal discharge that resembles cottage cheese
  • Vaginal soreness

In some women, particularly those with recurrent infections, the symptoms can be much more severe, causing itching and swelling so intense that it causes sores or tears.

Are there ways to prevent a yeast infection?

While most women will likely experience a yeast infection at some point in their lives, these precautions can greatly reduce your chances of developing one. We recommend that you:

  • Wear underwear with a cotton crotch.
  • Avoid tight-fitting panty hose.
  • Stop douching—this removes healthy vaginal bacteria.
  • Avoid tight underwear.
  • Avoid staying in hot tubs or hot baths for long periods of time.
  • Change out of wet attire—such as swimsuits and gym clothes—as soon as possible.
  • Use antibiotics only when necessary. Remember that antibiotics will not help if you have a cold or viral infection.

If you have a yeast infection, please schedule an appointment with us, particularly if you experience four or more in one year. We’ll need to determine the type of fungus that is causing the problem so we can tailor a care plan that will specifically address your situation.

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We’ve treated young women undergoing their first pelvic exam and older women who have entered menopause. Whether you’re trying to get pregnant or need help for painful, irregular periods, we consider it a privilege to treat you we have a full scope of gynecological services available to treat you.  We’ve provided the highest level of care for generations of women. We invite you to see why they have entrusted their care to our wonderful team of compassionate professionals. Contact us to schedule an appointment.

 

For more than 40 years, Chapel Hill OBGYN has served women in the Triangle area, sharing the joy of little miracles and supporting them during challenges. Our board-certified physicians and certified nurse midwives bring together the personal experience and convenience of a private practice with the state-of-the-art resources found at larger organizations. To schedule an appointment, please contact us for more information.


 

Recurrent Vaginal Yeast Infections | Michigan Medicine

Topic Overview

A vaginal yeast infection is thought to be recurrent when:

  • You have had four or more infections within 1 year.
  • The infections have caused symptoms.
  • The infections are not related to the use of antibiotics.

If you have a recurrent vaginal yeast infection, your doctor may do a culture to confirm that yeast is present. You may also be tested for certain conditions that could be making you more vulnerable to yeast overgrowth, such as diabetes.

The recommended first treatment for these yeast infections includes vaginal medicines for 7 to 14 days or a single dose of oral fluconazole, with a second dose repeated 3 days and a third dose 7 days later.footnote 1

This first treatment is then followed by at least 6 months of maintenance therapy. This could be oral or vaginal medicines.

Some women who are treated for recurrent yeast infections do not see their symptoms improve. These women may have another condition that is causing symptoms like those of a yeast infection. Further testing and treatment may be needed.

References

Citations

  1. Centers for Disease Control and Prevention (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR, 64(RR-03): 1–137. http://www.cdc.gov/std/tg2015. Accessed July 2, 2015. [Erratum in MMWR, 64(33): 924. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6433a9.htm?s_cid=mm6433a9_w. Accessed January 25, 2016.]

Credits

Current as of: July 17, 2020

Author: Healthwise Staff
Medical Review: Kathleen Romito MD – Family Medicine
Martin J. Gabica MD – Family Medicine
Deborah A. Penava BA, MD, FRCSC, MPH – Obstetrics and Gynecology

Current as of: July 17, 2020

Author:
Healthwise Staff

Medical Review:Kathleen Romito MD – Family Medicine & Martin J. Gabica MD – Family Medicine & Deborah A. Penava BA, MD, FRCSC, MPH – Obstetrics and Gynecology

Centers for Disease Control and Prevention (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR, 64(RR-03): 1-137. http://www.cdc.gov/std/tg2015. Accessed July 2, 2015. [Erratum in MMWR, 64(33): 924. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6433a9.htm?s_cid=mm6433a9_w. Accessed January 25, 2016.]

How I got rid of my recurring yeast infection

I sat on the toilet, ready to insert a clove of garlic into my vagina.

A month earlier, the symptoms of a yeast infection had seemingly gone away after a 1-day suppository treatment. When I felt the symptoms coming on again, I texted a friend who has a degree in public health.

“Do I need to see a doctor since I just had a yeast infection?”

My friend said I should try treating it with over-the-counter meds first. Or, I could try a less traditional approach, more associated with anti-vampires than anti-fungus: Inserting a clove of garlic into the vagina to cure a yeast infection. If it worked, I would save about $17 by not needing the meds.

I had some garlic in my kitchen, so I decided to give it a go. An article said to insert the clove at night and to anchor it to the outer world with a piece of floss. That night, my dutiful boyfriend Nick used a dentist’s pick to puncture the clove and secure the floss. In it went, and off we dozed.

I woke excitedly, walked to the bathroom and yanked the floss. The floss came out; the clove didn’t. Luckily, I was skilled at retrieving objects from my vagina because of my recent adoption of a menstrual cup. The clove came out, and I thought to myself, “Do I feel better?”

“I think it worked!” I texted my friend, foolishly.

A few hours later, the fire down under raged.

And so began a series of appointments, prescriptions, and Google searches that would persist November through January.

If you think you have a yeast infection…

Yeast infections are common: According to the CDC, nearly 75% of adult women will have at least one in their lifetime. Dr. Anne Burke, Associate Professor of Gynecology and Obstetrics at the Johns Hopkins University, has this advice for what to do if you think you have one:

  • If it’s your first time, see a health care provider to be evaluated and make sure it’s yeast.

  • If you’re a yeast veteran, get in touch with your provider and find out if you can just get over-the-counter medication or if your provider thinks you need an exam. BTW, if you’re having frequent infections (3 times a year or more), you should definitely go see your provider and find out what’s up.

  • Note: It’s your choice which suppository length you prefer, from 1-day to 7-day treatment. The shorter courses have a higher concentration of the medication in them. (Note that the longer treatment may work better for more severe infections—but it’s important to do the full course of treatment, even after you start to feel better.)

  • If you’re not feeling better in a few days, see your provider.

After the garlic treatment didn’t work, I began my treatment process:

  1. My primary care doc said it was likely a yeast infection, but she couldn’t do any tests to verify since I was menstruating. She gave me two doses of oral fluconazole. I took one right away, then the other 3 days later. I felt better while the medicine was in my system, but back to discomfort on day 7.

  2. I went to Planned Parenthood when I realized I wasn’t getting better and New Year’s holidays were coming up. (They were the only ones who could see me on a day’s notice—bless their hearts.) The nurse practitioner (NP) tested my discharge, found it was indeed a yeast infection, and prescribed me a 3-day suppository. Again, it felt better during treatment, but full-force pain returned on day 4.

  3. The NP then prescribed me double-duty: two doses of oral fluconazole + 6-day suppository. I felt better during treatment, and more relieved afterward than ever before.

Along with these treatments, I also tried the following (based on advice from friends, family, and acquaintances—not health care professionals):

a. Daily women’s probiotic

b. Daily water with grapefruit seed extract (Makes water taste very peculiar)

c. Wearing loose clothing (Not easy in the dead of Ohio winter)

d. Wearing only cotton underwear (Breathable, not beautiful)

e. Garlic (as described above)

What you should know about treatment and prevention

So what works best? Dr. Burke says that generally women prefer oral fluconazole treatment (less mess), but if you look at the numbers, stronger creams or suppositories work better for some yeast species. Her main advice for preventing yeast infections is to avoid douching or any other activity that affects your vagina’s pH balance.

According to Dr. Burke’s sources, no evidence points to the garlic treatment being effective. Putting yogurt in the vagina is another common home remedy about which there’s some limited, inconclusive evidence. In general, unscented products and non-soap cleansers are healthiest for your vulva, but they don’t specifically affect yeast.

Why might a yeast infection last longer than usual?

When I look back and try to figure out what happened in my situation, I can think of a few factors that may have contributed: It was the beginning of winter in Ohio, and I had a habit of wearing tights + leggings every day. My house is nearly 100 years old and not great at preserving heat, so sometimes, admittedly, I would go a few days without showering.

I realize I may not have gotten rid of the infection completely after the first occurrence in November—looking back I still had a little discomfort during sex, but it wasn’t bad enough to worry me. The infection may have lingered and flared up when trapped in my tights.

Eventually, sitting at a desk for an 8-hour workday was excruciating—the hot pain made me flinch and re-position every five minutes. When I went out with friends, I had to leave early so I could get home and go to sleep—the only time I wasn’t in pain.

It seemed the pain increased with stress, and I was constantly stressed because of the pain. The cycle continued.

If your infection lasts longer than usual, Dr. Burke suggests several potential reasons:

  • The infection may be incompletely treated, or not treated long enough.

  • If you don’t feel better after your first treatment, you may need a longer course or you may have a less common species of yeast that doesn’t respond to standard medication.

  • Or, you may not have a yeast infection—it could be bacterial vaginosis (BV) or a sexually transmitted infection (STI).

Finally, relief

After those three months, I woke up one day and realized I hadn’t been in pain in a few days. As painfully as it came in, the infection silently crept out. Now, as with any other time I’ve been sick, I really appreciate having a healthy vagina and follow the suggestions that my fantastic providers gave me.

My advice to anyone experiencing a long-term yeast infection is to relax and find your personal care plan. Work with providers to come up with the combination of medicine, nutrition, supplements, and stress relief that’s right for you.

Why Am I Getting So Many Yeast Infections?

Photo: Steve Lupton/Corbis

Women come to Dr. Jen Gunter’s vaginitis clinic in San Francisco and tell her they haven’t eaten cake or chocolate in two years because they think it will make their recurrent yeast infections worse. Others believe gluten is the culprit (“the whipping boy,” she says), while some think sex is partially to blame. Meanwhile, many of them have been using over-the-counter yeast infection treatments as well as douching and overwashing, all of which could lead to more itching and irritation in the long run. Gunter, a gynecologist and the director of pelvic pain and vulvovaginal disorders at Kaiser Permanente San Francisco, says true recurrent yeast infections, defined as four or more per year, are pretty rare — only 5 to 8 percent of women have them, though they’re more common among people with diabetes. But she says she sees patients every week who swear they have them and are desperate for relief.

“The problem is that women in the United States have become encultured to believe that any bothersome vaginal symptom is a yeast infection and they automatically go to treat that, when it’s not,” she says.

The main symptoms of a yeast infection are vaginal itching and burning, though women can also have a thick, white discharge. But, fun fact: Some women have discharge like that normally (sans itch) and think it’s a yeast infection, so they run to the drugstore. Other women are really experiencing irritation on their vulva, which is the vaginal opening and lips. It’s no surprise, then, that Dr. Gunter says only a quarter to a third of women correctly self-diagnose a yeast infection and by constantly treating it they could make thing worse for their nether regions. 

The vulva and vagina are very sensitive thanks to lots of nerve endings. Certain products and habits can irritate them and lead to itching and discomfort that women might confuse with a yeaster, says Dr. Gunter, who’s also a fellow of the American College of Obstetricians and Gynecologists. Chief among them are: douching and overwashing, removal of pubic hair either via waxing or shaving, benzocaine found in anti-itch creams like Vagisil, condoms with spermicide, and gel- or water-based lubes, which can irritate some people. (Nervous reader alert: If you don’t have problems, there’s no reason to stop doing or using any of these things, she says.)

Then there are conditions that can cause similar symptoms, including bacterial vaginosis, an imbalance in bacteria that can lead to discharge; trichomoniasis and herpes, STDs; vulvodynia, a nerve disorder; post-menopausal vaginal atrophy; and lichen simplex chronicus, a skin condition caused by scratching that can cause an eczemalike reaction on the vulva. “It’s really challenging because sometimes the symptoms are all similar whether it’s a yeast infection or bacterial vaginosis or even a urinary tract infection,” she says. This slew of potential causes can be frustrating for patients who feel increasingly desperate.

It’s both a blessing and a curse that there are treatments for yeast infections available over the counter. They’re convenient, but if you don’t have a yeast infection they may not give you relief, and, if you use them too much, you could kill off good bacteria and end up with even more yeast overgrowth. Some women just get a particularly virulent strain of yeast and that’s why they get the infection, but others have issues with the gatekeeper bacteria called lactobacilli that control the vaginal ecosystem (yes, that’s a thing). If those bacteria don’t work well, or get killed by repetitive use of anti-fungal creams — or even antibiotics for bad colds that you think are sinus infections — that can allow yeast to grow out of control. Cure, meet disease.

Vaginal itching won’t kill you, but it can definitely ruin your day. Or week. Or month. “It’s really sad because people are kind of marginalized, like, ‘Oh, it’s just a yeast infection,’ but it can really consume a lot of people’s lives,” says Dr. Gunter. So what should you do about it?

Dr. Gunter says that if your symptoms are itch-predominant and internal, not way out on the skin, and you haven’t done anything different like used a new soap or new kind of condom, you can certainly try an over-the-counter treatment. But the crucial thing is what happens after you finish the dose. “If you’re not better, you don’t assume it’s a yeast infection that didn’t get treated. You assume you made the wrong diagnosis,” Dr. Gunter says.

Those medicines are effective almost 90 percent of the time, and the chance you had the wrong diagnosis is greater than the chance that the treatment didn’t work. So don’t call your doctor and ask for a diflucan, which is the oral version of the treatment. This is a mistake she sees a lot, and it can lead to unintended consequences. “When you take an oral medicine, it’s not just killing yeast in your vagina, it’s killing yeast in your bowel and you need yeast in your bowel, it’s part of your normal flora,” she says. She’s not opposed to using the oral as a first-line treatment — it’s a matter of personal preference — but it’s not a solution if Monistat’s not working.

If an OTC treatment didn’t work (or you’re unsure you have a yeast infection in the first place), ask your gyno for a yeast culture. Since symptoms of a yeast infection can vary, doctors treat yeast cultures as the gold standard. The results come back within 48 to 72 hours and they’re highly accurate. “If you don’t have a positive yeast culture, you don’t have a yeast infection,” she says. Once you know that, you and your doctor can move on to other possible causes.

For any woman with yeast-infection-like symptoms, she recommends taking a good old antihistamine like Zyrtec, Claritin, or Allegra, which will reduce inflammation and can help give you relief while you’re waiting for medicine to do its thing, or for lab results to come back. A topical steroid like one percent hydrocortisone applied around the vaginal opening can also help relieve itching, she says.

As for the women who tell Dr. Gunter that they’ve changed their diet over this, she offers them some nonmedical advice. “Sometimes I’ll say to them, ‘Leave here and go buy chocolate, please.’ Like, enjoy yourself. You’ve been doing this for years and you’re not better. But people are desperate and when people are desperate they don’t think straight and it just breaks my heart.” A doctor who prescribes chocolate: Sign us up.

Oh No! Not Another Yeast Infection

Frequent yeast infections? Why me?

About 5% of women suffer from recurrent yeast infections (more than 4 infections in the last year, or at least 3 infections in the last year that are unrelated to antibiotic use). It can be frustrating and uncomfortable. Why do frequent yeast infections happen? Here are some of the more common reasons.

Have you recently been taking a medication? Frequent antibiotic use can kill healthy bacteria in the vagina and allow yeast to flourish, leading to frequent yeast infections. Medications that suppress the immune system (such as cancer and transplant medications) can make it harder for the body to fight off yeast infections, resulting in more frequent infections.

What do you use for birth control? Spermicides – the gels, foams and creams that are used with diaphragms and condoms – can kill healthy bacteria and make it easier for yeast to grow and spread in the vagina. Birth control pills containing estrogen, especially high-dose pills, can also make it easier for yeast to grow in the vagina.

Is your immune system weakened? A weak immune system makes it harder for the body to fight infections, including yeast infections.

Is sugar a problem for you? If you have diabetes, frequent yeast infections may be a sign that your condition is not well controlled and your blood sugars are too high. It has been suggested that a diet that is too high in sugar might contribute to frequent yeast infections, but medical studies have not been able to prove this.

Are your clothes to blame? Tight-fitting clothes, particularly synthetic materials, can lead to increased moisture and heat in the vaginal area, which can make it easier for yeast to grow. Choosing natural materials like cotton allows the area to remain cooler and drier.

Are you having frequent sex? Frequent sexual activity may also irritate the vaginal area and increase the risk of developing yeast infections. It is not clear whether yeast infections may be sexually transmitted. Approximately half of all women who experience recurrent yeast infections have a sexual partner who is also infected. But so far no studies have shown that treating a woman’s sexual partner helps prevent recurrent yeast infections.

Are you using the wrong treatment? Sometimes frequent infections occur because the treatment selected is not effective against the type of yeast causing the infection. Although Candida albicans is the most common type of yeast causing yeast infections, harder-to-treat types of yeast, such as Candida glabrata, can also infect the vagina and are more common with recurrent infections. Resistance, where the yeast changes its genetic makeup so it is harder to treat, is another cause of frequent yeast infections.

Other things that make your infection more likely to come back include forgetting to use the treatment according to directions, missing doses, or stopping before the medication has all been used.

If you are suffering from frequent yeast infections, see your doctor before treating them yourself. Your doctor can help you find out why you are having frequent infections and suggest an effective treatment.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Oh-No-Not-Another-Yeast-Infection

Is it time to see my doctor about my yeast infections?

Did you know that your yeast infection may not be a yeast infection at all? There are many reasons for vaginal irritation, anywhere from allergies and bacteria to chemical causes. The irritation you’re experiencing may be due to yeast again, but it also may not. Here are a few situations in which you should visit your doctor to be sure.

The infection keeps coming back. If your last infection was less than 2 months ago, or if you have had 4 or more infections in the last year, see your doctor. Frequent yeast infections can be a sign of an underlying health problem or ineffective self-treatment. Your doctor can help uncover the cause and find a treatment that works.

The treatment you tried isn’t working. Even though you checked to make sure that you used your last treatment exactly as recommended, it may just not be the right one for your infection. You may have a resistant infection, or you may be infected with a type of yeast for which the medication you tried was not effective. Your doctor can help you find out why the treatment didn’t work, and can recommend one that will.

You’re pregnant or breast-feeding. Your doctor can help you choose a treatment option that is effective for you and safe for your baby.

You’re having other symptoms or are not sure if it’s a yeast infection. If you have a fever, pelvic pain, or a smelly or coloured discharge, see your doctor. These are signs that you may have a different type of infection. Yeast infection treatments will not work for infections that aren’t caused by yeast. It’s important to see your doctor for a proper diagnosis and treatment if you have other symptoms.

You have diabetes or other health conditions. If you have diabetes or other health conditions, especially conditions that affect your immune system, see your doctor. Frequent yeast infections may be a sign that your condition is not well-controlled. You may require a different treatment.

If any of these situations applies to you, see your doctor. Ask your doctor for a treatment that will treat all types of yeast. Getting a proper diagnosis is important. Many women think they have a yeast infection when, in fact, they have another health condition. Sexually transmitted infections (also known by the older term “STDs”) often mimic the symptoms of yeast infections, and can be harmful if left untreated. Plus, a proper diagnosis will help pinpoint the cause of your frequent infections and make it easier to get rid of them for good!

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Oh-No-Not-Another-Yeast-Infection

Getting rid of the yeast infection for good!

Do your yeast infections keep coming back? Have you tried to treat them but it didn’t work? Have you had more than four yeast infections in the last year? If so, don’t try to fight the infections alone! Ask your doctor for help.

Your doctor can help you get rid of stubborn or frequent yeast infections. The first step is to get a proper diagnosis. This is important because what you think is a yeast infection may, in fact, be something else, requiring a different treatment. Some studies showed that over half of women with vaginal irritation misdiagnosed themselves! Or, you might be infected with a particularly stubborn yeast that requires stronger treatment. To diagnose your infection, the doctor will do a physical examination and take a sample of your discharge. Your doctor will also need to know about any medications you may be taking and any health conditions you may have, as these may be increasing your risk of yeast infections.

If your doctor confirms that your current symptoms are due to a yeast infection, the doctor will recommend a medication to get rid of the infection. If you have been having frequent infections, your doctor may recommend that you follow a “maintenance treatment” to prevent the infections from coming back.

Maintenance treatment involves using a yeast infection medication regularly for up to 6 months. Some treatments are taken daily, while others are taken twice weekly, weekly, or even monthly. The maintenance treatment can cut your risk of another infection in half. If you continue to suffer from frequent yeast infections after you stop the maintenance treatment, your doctor may recommend you take the medication for a longer period of time, usually up to 12 months.

If you have frequent yeast infections it is important to become an active participant in your own health and well-being. Treatments vary based on medication, frequency and duration of treatment.  It’s important to find a plan that will work best for you.

If you’ve had “one too many” yeast infections this year, make an appointment and talk to your doctor about what you can do. Whether you have a resistant strain of yeast or have several risk factors, your doctor can help you get a treatment that’s right for you. If you are suffering from frequent infections, it may be caused by a type of yeast that is tougher to treat. Ask your doctor about whether there is a treatment that will cover a broader range of yeasts.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Oh-No-Not-Another-Yeast-Infection

Finally my yeast infection is gone. What can I do to keep it that way?

Finally, your latest yeast infection is gone! If you’ve been suffering from frequent yeast infections, you may be wondering what you can do to avoid them in the future. There are many ways to prevent yeast infections.

Find the right medication for you. If you’ve been having more than 4 yeast infections in the last year, your doctor may recommend that you take yeast infection medication regularly for 6 months to prevent the infections from coming back. Depending on the medication used, the treatment may be given daily, weekly, every 2 weeks, or monthly. This should only be done under the supervision of your doctor.

When talking to your doctor, it’s important to remember that different medications are available to meet different needs. For example, if you are concerned about taking a pill by mouth, vaginal products are available.

Keep other health conditions under control. Frequent yeast infections may be a sign of an underlying health problem such as diabetes. If you have a health condition and are also troubled by yeast infections, see your doctor. The doctor can investigate whether your health condition may be increasing your risk of yeast infections and help you control it. Better control of certain health conditions, such as diabetes and immune system problems, can help decrease your chances of having another yeast infection.

Keep clean, dry, and comfortable. Vaginal deodorants, sprays, harsh cleansers, douches, and perfumed soaps can irritate the area, making it more prone to infection. Avoid using these products. Plain soap and water will do just fine. After using the bathroom, wipe from front to back to avoid contaminating the vaginal area with fecal bacteria. Wear clothing that is not tight in the crotch, and choose cotton (or cotton-crotch) underwear instead of synthetic. Dry your vaginal area thoroughly after bathing or showering. Taking these steps will allow the vaginal area to breathe and keep out the heat and moisture that can increase the risk of yeast infection

Eat a yogurt every day. Studies have shown that eating 240 mL (about one cup) of yogurt per day can reduce your risk of yeast infections. But not just any yogurt – be sure to choose one that has the active bacteria Lactobacillus acidophilus, sometimes referred to as probiotic yogurt. More studies are needed to prove the effective use of yogurt for yeast infections. If you are prescribed an antibiotic, speak to your doctor or pharmacist about your risk of developing a yeast infection and about using over-the-counter probiotics.

If you take these steps and still find that you’re having trouble with yeast infections, see your doctor for help. You don’t have to suffer from frequent yeast infections. Effective treatments are available. Next time you have a yeast infection, make an appointment and see your doctor rather than treating it yourself. Your doctor can help you find out why you are having frequent infections and can help you find an effective treatment that is right for you.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Oh-No-Not-Another-Yeast-Infection

90,000 CPA – Chronic pulmonary aspergillosis

Chronic pulmonary aspergillosis is a long-term period. Aspergillus lung infection; Aspergillus fumigatus is almost always a responsible species. CPA sufferers have a healthy immune system that normally eradicates the infection completely. Consequently, the fungus cannot quickly penetrate the patient, but it manages to populate parts of the body where it can find support.

Suitable areas of the body for infection are where the fungus first gained access; airways or sinuses are common because fungal spores spread well in the air.Secondly, it needs to evade the immune system, so it usually lives in cavities where there is less contact with the immune system – such as damaged lung tissue left behind by tuberculosis or a similar infection. The debris left behind by the original infection provides the “support” that the fungus needs.

Once formed, the fungus may grow slowly, confining itself to the tissues surrounding the cavity (where the patient’s immune system can still fight the infection). It can be hidden for years with few symptoms, but in some cases it can begin to erode surrounding tissue – possibly due to scarring caused by inflammation when the fungus touches the sides of the cavity.It is like mushroom ball, is also called aspergilloma, is developing. Not all patients with CPA develop aspergilloma.

It does not immediately threaten health, unless the erosion of the main blood vessel is accompanied by bleeding. Sometimes severe blood loss is possible; this is called hemoptysis and requires immediate treatment at hospital .

NB : Chronic pulmonary aspergillosis (CPA) and chronic invasive pulmonary aspergillosis (HILA) have been used in the past and this has caused confusion.Currently, CIPA is no longer officially used to describe this disease. Invasive aspergillosis is another disease.

Chronic pulmonary aspergillosis encompasses at least three subcategories of chronic infection:

  • Chronic pulmonary aspergillosis (CCPA), which is defined by one or more cavities, with or without a fungal ball.
  • Aspergilloma is the term used for a fungus growing in a cavity.A CPA patient with aspergilloma may see improvement or slight change over several years. There may be multiple symptoms or just a cough.
  • Chronic fibrosing pulmonary aspergillosis (CFPA) is essentially a CCPA that is in an advanced stage of development and the lung is severely damaged.

CT scan from patients with various forms of chronic pulmonary aspergillosis. (A) Simple aspergilloma; (B) chronic cavitary pulmonary aspergillosis; (B) chronic fibrosing pulmonary aspergillosis; (D) Aspergillus nodule. Figure taken from Kosmidis C, Denning DW, Clinical spectrum of pulmonary aspergillosis, thorax 2015; 70: 270-277

symptoms

Patients with aspergillomas have several specific symptoms, but 50-90% have some coughing up blood.
For other patients with CPA, symptoms may include weight loss, fatigue, coughing, hemoptysis (bleeding in the lungs), and shortness of breath, usually for more than 3 months.

Diagnostics

Most CPA patients have underlying lung disease.These include tuberculosis, previous treatment for lung cancer, sarcoidosis, emphysema, and COPD. A chest x-ray or computed tomography may show one or more lung cavities, and blood tests may be positive for Aspergillus antibody . Galactomannan analysis is a more reliable test for Aspergillus contact. A sputum sample can be grown in an attempt to see Aspergillus grow. Sometimes a biopsy is taken and checked.

Diagnostics is difficult and often requires a specialist.This is one of the main services offered by the National Aspergillosis Center in Manchester, UK where you can seek advice.

Click here for more diagnostic information

treatment

Patients with solitary aspergilloma generally do well with surgery and are best given pre- and postoperative antifungal medications to prevent other complications. In more severe cases (CCPA), lifelong use of antifungal agents is normal, along with regular X-rays to monitor progress.It is important to monitor blood levels of antifungal drugs to ensure optimal dosage, as people differ in how their bodies process these drugs.

If bleeding occurs and surgery is not possible, then other treatments can be used to limit blood loss. For example, transcemic acid can be given to encourage clotting. If this fails and bleeding becomes excessive, embolization is performed through a catheter ( cm.report on blood loss limitation by a consultant radiologist at the National Aspergillosis Center, Ray Ashley ).

Click here for more information on treatment

Forecast

For most patients, CPA is a lifelong disease. 84% of patients feel good after surgery if that’s an option. In less than 10% of cases, the disease spontaneously disappears. The vast majority of CPA patients require chronic medical treatment.In most cases, the main goals of therapy are to reduce symptoms and prevent disease progression.

Sometimes patients are asymptomatic and do not progress even without therapy. At the other end of the spectrum are patients with a high degree of symptoms, whose disease progresses despite high intensity antifungal therapy, sometimes with combination immunotherapy. Delaying progression and, in particular, minimizing the loss of lung function is a key goal of therapy, which, unfortunately, is not always achieved; In addition, weight gain, reduced fatigue, reduced coughing, sputum production, hemoptysis, and shortness of breath are all valuable benefits of long-term antifungal therapy that are also not always achievable.

Further information

There is a paper describing all aspects of the CPA on the Aspergillus website , Written by Professor David Denning (director of the National Center for Aspergillosis ) and colleagues, it is intended for people with a medical background.

For more information on the types of aspergillosis, their symptoms and treatment, visit the following links:

90,000 In India, a case of “yellow fungus” was recorded in a patient with COVID-19 :: Society :: RBK

Video

Mortality from the disease exceeds 50%, and mucormycosis is especially dangerous for diabetic patients infected with COVID-19.”Diabetes lowers the body’s immune defenses, the coronavirus exacerbates it, and then the steroids that help fight COVID-19 act as fuel for the fire,” explained Dr. Akshay Nair from Mumbai.

Read on RBK Pro

In addition, the country recorded cases of “white fungus” – a type of infection that affects the chest and lungs. The patient may also experience swelling and persistent headaches.

Covid records: what is happening in India.Photo report

According to the Times of India, experts believe that the “yellow fungus” can be much more dangerous than the other two types of infection, as it can cause multiple organ failure and tissue necrosis.Most fungal infections are due to unsanitary conditions, and doctors also believe that the fungus can be caused by the use of steroids in the treatment of severe forms of coronavirus. The drugs reduce inflammation in the lungs, but at the same time, they lower immunity and can raise blood sugar levels.

Director of the All India Institute of Medical Sciences in New Delhi, Randip Guleria, stated that many terms are used for fungal infections in patients recovering from COVID-19 and can be misleading and confusing.“The types of infections we see most often are mucormycosis, candidiasis and aspergillosis,” he explained. According to the specialist, mucormycosis is more common when a patient with COVID-19 also suffers from diabetes or is taking steroids. Candidiasis has occurred in people with weak immunity and in those who took immunosuppressive drugs. Aspergillosis is the least common disease, and the infection affects the lungs and can cause allergic reactions.

Rospotrebnadzor believes that in Russia there is no need to fear the spread of “black fungus”, since India has a different climatic zone and a different food culture.Virologists interviewed by RBC also reported a low probability of the disease coming to Russia.

90,000 dangerous fungus is merciless to coronavirus patients

Two states in India have announced an epidemic of “black mold” at once. According to the authorities, the fungus has already infected 1,500 patients. Local doctors say that those who have recently suffered from COVID-19 are most at risk of contracting “black mold”.

Against the backdrop of the COVID-19 coronavirus pandemic in India, a new epidemic appears to be developing. This time a fungal infection, also known as the “black mold” epidemic. It primarily affects patients with coronavirus who are in hospital.

Today, India’s central authorities, in particular the Ministry of Health, have called on state leaders and all public and private hospitals to follow epidemiological protocols for this infection.And also inform the center about all confirmed cases of “black fungus”.

On the eve of the government of Rajasthan announced the fixation in the state of a full-scale epidemic of “black fungus” or mucormycosis due to a sharp increase in the number of infections among patients with COVID-19. More than 100 cases of mucormycosis have already been recorded in the state, and special departments are being set up in hospitals to fight it. More than 230 cases have been reported in the state of Haryana, neighboring Delhi. And in the state of Maharashtra, two thousand cases of black fungus are reported, and there have already been 90 deaths.

But, in addition to the “black fungus”, in one of the cities of Bihar state, for the first time, a “white fungus” was discovered – a type of infection that is even more dangerous and affects both the lungs and the skin, nails and intestines. It is reported that this “white fungus”, in addition to four patients in the hospital, was infected by one of the doctors.

Even before the coronavirus pandemic, black fungus was more common in India than in other countries. Its spores are found in earth, dust and organic decomposition products.The “black fungus” most often enters the human body through mechanical ventilation devices. Therefore, it is not surprising that the disease most often occurs in patients with coronavirus who have been in intensive care units for a long time, and in addition, in patients with diabetes, and in those who receive large doses of steroids.

According to doctors, this fungal infection affects the nasopharynx, eyes and lungs of a person, and in the case of patients with coronavirus, it is fatal.The mortality rate for this disease is between 30 and 85 percent.

“Recently, a new problem has arisen in the form of a fungal infection, namely mucormycosis. Many cases have been reported among patients with COVID-19, especially those on steroid therapy and who have sugar problems. This fungal infection leads to long-term illness and mortality among patients with COVID-19. Its treatment requires an interdisciplinary approach, including eye surgeons, ENT specialists, neurosurgeons, maxillofacial surgeons and others, as well as treatment with amphotericin B as an antifungal drug, “said the spokesman for the Indian Ministry of Health Love Agarwal.

The total number of coronavirus cases has already exceeded 30 million cases. Today, the Indian authorities have issued new rules and guidelines for citizens, which say that, according to the latest research, the virus can travel up to 10 meters through the air and remain active indoors after an infected person has left.

In this regard, the new recommendations prescribe the wearing of two masks in public places, as well as airing the premises every few minutes.Today, India has recorded a quarter of a million new cases of COVID-19, which suggests a kind of plateau that is being established in this catastrophic wave of coronavirus in India.

90,000 HIV and AIDS in the oral cavity: symptoms, treatment and prevention

What is HIV and AIDS?
HIV is the human immunodeficiency virus that causes the disease – HIV infection, the last stage of which is known as AIDS. The spread of HIV infection is associated with the ingress of biofluids containing the virus directly into the human bloodstream (through blood transfusion, use of syringes and needles infected with the virus) and unprotected sexual intercourse.In addition, the transmission of the virus from an infected mother to her child is possible during pregnancy and childbirth or during breastfeeding.

AIDS – Acquired Immunodeficiency Syndrome – is a late stage of HIV infection, when disorders in the functioning of the immune system increase to such an extent that the body is practically unable to fight certain diseases and infections. The emergence and progression of opportunistic infections is associated with a decrease in the overall resistance of the body.

How do I know if I have HIV or AIDS?
Dental problems such as bleeding gums, oral herpes, and fungal and candidal infections may be the first symptoms of AIDS. However, this does not mean that you have this disease only if you have the listed symptoms, as they are common in the entire population. The only way to diagnose HIV infection is through laboratory tests. Check with your doctor.

A positive test result for HIV infection does not mean that the patient has AIDS. AIDS is a medical diagnosis that can only be made by a doctor based on certain criteria. At the same time, symptoms cannot be relied upon to diagnose HIV infection. Many people living with HIV have had no symptoms of infection for many years.

The following symptoms may indicate the possibility of HIV infection:

  • Rapid weight loss
  • Dry cough
  • Recurring periods of fever and profuse night sweats
  • Severe fatigue, unexplained by other causes
  • Swelling and inflammation of the lymph nodes – axillary, inguinal and cervical
  • Diarrhea lasting more than a week
  • Whitish spots or atypical ulcers of the tongue, mouth or larynx
  • Pneumonia
  • Reddish, pink or bluish patches under or on the surface of the skin, or in the mouth, nose or eyelids
  • Amnesia and other neurological diseases

How to prevent HIV and AIDS?
HIV infection can be transmitted by direct ingestion of blood, semen, vaginal secretions or breast milk (for babies) directly into the human body.The best way to protect yourself from HIV is to avoid activities that increase the risk of transmission of the virus. Consult your doctor for information on how to prevent transmission and transmission of HIV / AIDS.

Many patients are concerned about the risk of HIV transmission through blood transfusions. Since 1985, in the United States, all donated blood has been screened for HIV infection. The US blood supply is considered one of the safest in the world. In Russia, the analysis of donated blood for HIV is also mandatory.

Can you get HIV in the dentist’s office?
Due to the invasiveness of dental procedures, many patients fear HIV transmission during dental treatment. To prevent the transmission of infections, including HIV, from patient to patient in medicine, universal safety measures are applied.

These measures require the use of disposable gloves, masks and goggles by dentists, hygienists and their assistants, as well as the sterilization of instruments (for example, drill bits) and others in accordance with instructions and regulations.Instruments that cannot be sterilized are disposed of in special containers. After each new contact with the patient, the doctor throws away the used gloves, thoroughly washes his hands and puts on a new pair of gloves.

If you are concerned, ask your dentist about universal safety measures – it only takes a few minutes and will help you overcome your fear.

How to treat HIV and AIDS?
Modern therapies slow the progression of HIV infection and the destruction of the human immune system.There are other treatments that can prevent or control the illnesses associated with HIV infection. As with any diagnosis, early detection is the key to more effective treatment.

Department of Immunopathology of Children No. 3

Doctors of the department

Profile diseases:

Allergopathology and immunodeficiencies of childhood.

  • Allergic diseases: bronchial asthma, seasonal and perennial allergic rhinitis and conjunctivitis, atopic dermatitis, urticaria, angioedema (Quincke’s edema), etc.;
  • Primary immunodeficiency states: total and partial antibody deficiency syndromes, hyper-IgE syndrome, chronic granulomatous disease, chronic generalized candidiasis, combined immune deficiency with ataxia-telangiectasia, Wiskott-Aldrich syndrome, hyper-IgD syndrome, etc .;
  • Secondary immunodeficiencies and their phenocopy: recurrent and chronic viral, bacterial and fungal infections, often and long-term ill children;
  • Vaccinal reactions Vaccination against the background of immunopathology and allergies.

The department uses all the diagnostic capabilities provided by the laboratories of the clinical and experimental sectors of the Institute.
Allergy testing is widely used, both laboratory (in vitro) and skin tests (scarification, prick tests).
An in-depth study of the immune status of children with various diseases is being carried out.

The main direction of the treatment work of the department is immunotherapy (allergen-specific immunotherapy (ASIT) – allergic vaccination; immunomodulatory and substitution immunotherapy).

Patients are accommodated in boxes, 1-2 and 4-bed wards.
Children under 7 years old are usually hospitalized with their parents.
The day hospital is functioning.

Hospitalization is carried out in a planned manner (Mon-Fri from 9.00 to 12.00) according to compulsory medical insurance (CHI) policies and on a paid basis after preliminary consultation.

An appointment for a consultation is made

in person (daily from 9.30 to 15.00 in office number 122),
by phone: +7 (499) 311-67-78 (children’s registration).

90,000 Caution: shingles! – news from the veterinary clinic “Center”

Almost every loving owner knows that his four-legged friend can suffer from the same ailments as you and I. Diseases of the respiratory system, gastrointestinal tract, heart, liver, kidneys, obesity and many other pathologies occur in our pets as often as we do. In addition, there are infectious diseases transmitted from animals to humans.One of them is dermatophytosis or lichen. So what is it?

WHAT IS LIVING?

In medicine, the disease is called dermatophytosis. More recently, animals suffering from this disease were euthanized due to the threat of infection of people in contact with them. We live in the 21st century! And of course, lichen can be cured with timely diagnosis and proper therapy.

So, let’s get to know this disease better, so that, as they say, to know the enemy by sight. Dermatophytosis is an infectious disease of keratinized tissues (skin, hair, nails) caused by fungi of the species Microsporum, Trichophyton or Epidermophyton.Fungal infections are less common in cats and dogs than other skin diseases, but deserve special attention due to the threat of infection in humans and other animals.

In many people with normal immune systems, as in many healthy pets, dermatophyte infestations result in a limited scaly lesion that responds readily to topical therapy and tends to heal spontaneously within a few months. Some patients develop exudative dermatitis, which is usually very difficult to treat.This development of the disease is more common in newborns and young children, very elderly and immunosuppressed (HIV-positive or undergoing chemotherapy) people. In animals, a predisposition to dermatophytosis with vivid clinical manifestations is observed at the age of up to 12 months (imperfect cellular immunity, deficiency of nutrients, especially proteins, fatty acids and vitamin A, viral diseases) and in adult animals under severe stress or immunosuppression.Also, factors predisposing to infection are parasitic invasions, high humidity and ambient temperature, and damage to the skin.

Dermatophytes can be isolated from the skin and hair of cats (especially those kept in nurseries and shelters that visit exhibitions) that do not have visible lesions (more often in Persian kittens). In places of mass concentration of animals, a serious problem is the spread of fungal spores, which retain their viability for 18 months (according to some sources, up to 52 months) in the environment.Unfortunately, animals and people can get dermatophytosis many times.

Immunity to this disease is not developed, although with subsequent infection, there is a faster onset of clinical manifestations and a tendency to reduce the duration of the disease.

CLINICAL PICTURE OF DISEASE

Clinical symptoms of Microsporum canis disease in cats and dogs can range from asymptomatic carriage to skin lesions with scab formation.The typical manifestation of the disease is single or multiple, rapidly spreading ring-shaped lesions of a round or irregular shape, accompanied by redness, scales and patches of baldness, more often found on the head and limbs. Itching and inflammation are usually minimal. In rare cases, lichen can manifest itself as extensive baldness of the skin, damage to the claws, claw beds, and can even mimic the volumetric formation of the skin.

DIAGNOSTICS

A specialist will help you understand the situation, conduct a thorough clinical examination and the necessary diagnostic procedures.

1. Inspection of an animal in a darkened room with a Wood’s lamp may show the characteristic apple-green glow (fluorescence) in some cases of disease caused by Microsporum canis.

2. Microscopic examination of hair and crusts from the site of injury is carried out to detect fungal spores.

3. Sowing the material on special nutrient media will help your pet get the final diagnosis.

4. For examination of animals in order to identify asymptomatic carriers of infection, the hair is combed out with a sterile toothbrush or comb, followed by sowing on a nutrient medium.

TREATMENT

For the treatment of dermatophytosis, the treatment of lesions is carried out, although such treatment is less important in animals than for humans. Our pets are covered with hair, which reduces the effectiveness of these procedures. Therefore, local therapy should be considered as an adjunctive treatment. With extensive lesions, it is considered more effective to wash the animals with special shampoos after preliminary shearing and destruction of the hair. This procedure can significantly reduce the contamination of the external environment with dermatophyte spores.Existing vaccines against microsporia and trichophytosis should be used as part of therapy simultaneously with a systemic antifungal drug. Treatment should be continued for a minimum of 4-6 weeks and should not be stopped until a negative culture is obtained. This is very important as the culture result can be positive long after visible clinical recovery.

ENVIRONMENTAL PROCESSING

Rooms in the home where the sick animal is located must be vacuumed daily to remove infected hair and spores.Chlorine-resistant surfaces should be treated daily with household bleach 1:10 with water. Where possible, 10% formalin solution, steam and boiling are used.

In conclusion, I would like to note that due to the variety of clinical manifestations, you should not take the liberty of diagnosing and treating the animal yourself. The danger of error is very great. The presence of similar lesions in humans or animals in contact with the patient may be a hint of a dermatophyte infection, but treatment should never be started without a definitive diagnosis.

Veterinary dermatologist VK “Center” Levyatova N.I.

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