Battaglia F, Mariani L, Anglana F, Milite V, Quattrini M, Plotti F, Tomao F, Plotti G
UOC Ginecologia e Ostetricia, Dipartimento Materno Infantile, A.C.O. San Filippo Neri, Roma.
Minerva Ginecol. 2005 Apr;57(2):131-9.
The vulvovaginal candidiasis represents, after the bacterial vaginosis, the most frequent cause of vaginal affection. It is esteemed that around the 75% of the women of reproductive age suffered from an episode of vulvovaginitis from candida and 40-45% have had more episodes, of which 10-20% in complicated form. The kind of candida more frequently isolated in the vagina of symptomatic women is the Candida albicans: in the 10-20% of the cases the agent is present in absence of symptomatology, and we can almost consider it a saprophytic. On the other hand, always with greater frequency fetterses can be isolated of not albicans Candida, particularly the tropicalis and the glabrata kind, usually resistant to the common therapies. The classification of the vulvovaginal candidiasis proposed by Sobel, and by now universally approved, foresees 2 clinical forms of vulvovaginal candidiasis, the vulvovaginitis from not complicated candida (VVC) and the vulvovaginitis from complicated candida (VVCC): different for pathogenesis, elapsed clinical, symptomatology and frequency. They have to be considered in the substance 2 different nosological entities, and they request a diagnostic approach and a well different therapeutic appointment. In this study we will shortly reassume the principal characteristics of it, detaining us on the most recent acquisitions in theme of therapy. The base medicines of ac. boric, to parity of effectiveness, seem to introduce the most contained cost and the best compliance, and they offer him to a complementary use or, in some cases, alternative to the more you consolidate therapies with azoli.
外阴阴道念珠菌病是仅次于细菌性阴道病的最常见的阴道感染原因。据估计,约75%的育龄妇女曾患过念珠菌性外阴阴道炎,40 - 45%的人有过多次发作,其中10 - 20%为复杂型。在有症状女性阴道中最常分离出的念珠菌种类是白色念珠菌:在10 - 20%的病例中,该病原体在无症状时存在,我们几乎可以将其视为腐生菌。另一方面,非白色念珠菌,特别是热带念珠菌和光滑念珠菌,也更常被分离出来,它们通常对常用治疗有耐药性。Sobel提出的、现已被普遍认可的外阴阴道念珠菌病分类法,预见了外阴阴道念珠菌病的2种临床形式,即非复杂性念珠菌性外阴阴道炎(VVC)和复杂性念珠菌性外阴阴道炎(VVCC):在发病机制、病程、症状和发病率方面有所不同。它们本质上应被视为2种不同的疾病实体,并需要不同的诊断方法和截然不同的治疗方案。在本研究中,我们将简要回顾其主要特征,并关注治疗方面的最新进展。在疗效相当的情况下,硼酸溶液似乎成本最低且依从性最佳,它们可作为补充用药,或在某些情况下替代与唑类药物联合使用的更巩固的治疗方法。