1Northern Clinical School, University of Sydney; 2Department of Dermatology, Royal North Shore Hospital, St Leonards, NSW, Australia; 3Louisiana State University Health Sciences Center School of Dentistry, New Orleans, LA; and 4University of Western Sydney, NSW, Australia.
J Low Genit Tract Dis. 2014 Jan;18(1):31-8. doi: 10.1097/LGT.0b013e318287aced.
Although recurrent vulvovaginal candidiasis is defined as 4 or more discrete attacks of vulvovaginal candidiasis per year, there is no diagnostic nomenclature or definition for the many women who are chronically symptomatic. This study aims to establish and propose a definition and a set of diagnostic criteria, which would enable clinicians to promptly identify and treat women with chronic vulvovaginal candidiasis (CVVC).
Prospective cohort study.
Public and private vulvar dermatology outpatient clinics in Sydney, Australia.
Data were obtained prospectively from 50 women with presumptive CVVC and 42 controls. Historical and clinical features of CVVC identified by expert consensus were compared between the 2 groups. Diagnostic criteria were then prospectively applied to a further 163 patients to verify their accuracy.
Signs and symptoms diagnostic of CVVC.
The following characteristics were found to be significantly more common in women with CVVC compared to controls (p ≤ .001): a history of positive vaginal Candida swab, discharge, dyspareunia, soreness, swelling, cyclicity, and exacerbation of symptoms with antibiotics.
We propose that CVVC can be confidently diagnosed using the major criteria of a chronic nonspecific and nonerosive vulvovaginitis that includes at least 5 or more properties from the following criteria: soreness, dyspareunia, positive vaginal swab either at presentation or in the past, previous response to antifungal medication, exacerbation with antibiotics, cyclicity, swelling, and discharge. This condition responds reliably to oral antifungal medication.
尽管复发性外阴阴道念珠菌病被定义为每年 4 次或以上的外阴阴道念珠菌病离散发作，但对于许多慢性症状的女性，尚无诊断命名法或定义。本研究旨在建立并提出一个定义和一套诊断标准，使临床医生能够及时识别和治疗患有慢性外阴阴道念珠菌病（CVVC）的女性。
前瞻性队列研究。
澳大利亚悉尼的公立和私立外阴皮肤科门诊。
前瞻性地从 50 名疑似 CVVC 女性和 42 名对照者中获得数据。通过专家共识确定的 CVVC 的历史和临床特征在两组之间进行了比较。然后，前瞻性地将诊断标准应用于另外 163 名患者，以验证其准确性。
诊断 CVVC 的体征和症状。
与对照组相比，CVVC 女性具有以下特征更为常见（p≤0.001）：阴道念珠菌涂片阳性、分泌物、性交痛、疼痛、肿胀、周期性和抗生素治疗后症状恶化的病史。
我们建议可以使用以下主要标准来明确诊断 CVVC：包括至少 5 种以下特征的慢性非特异性和非侵蚀性外阴阴道炎：疼痛、性交痛、目前或过去阴道涂片阳性、既往抗真菌药物治疗有效、抗生素治疗后恶化、周期性、肿胀和分泌物。这种情况对口服抗真菌药物有可靠的反应。
