White D J, Johnson E M, Warnock D W
Department of Genitourinary Medicine, Birmingham General Hospital, UK.
Genitourin Med. 1993 Apr;69(2):112-4. doi: 10.1136/sti.69.2.112.
CASE REPORT--SUBJECTS--Three cases are described of long-standing vaginal candidosis due to Candida glabrata. These had failed to respond to local and systemic antifungals. In each case the infecting strain appeared resistant to a range of azole drugs in vitro. CLINICAL COURSE--Case one--This patient recovered following prolonged treatment with oral itraconazole in combination with oral and vaginal nystatin. Case two. Yeasts were eradicated from this patient following cyclical treatment with oral dydrogesterone; prolonged vaginal treatment with nystatin may have helped. Case three. This patient did not respond to a prolonged course of oral itraconazole in combination with vaginal and oral nystatin, oral medroxyprogesterone or intravaginal boric acid. Eradication of C glabrata was finally achieved by local application of 1% gentian violet. Shortly after eradication of the C glabrata infection, both Case two and Case three developed infections with other Candida species responsive to azole antifungals.
病例报告——研究对象——描述了3例由光滑念珠菌引起的长期阴道念珠菌病。这些病例对局部和全身抗真菌药物均无反应。在每个病例中，感染菌株在体外对一系列唑类药物均表现出耐药性。临床病程——病例一——该患者在口服伊曲康唑联合口服及阴道用制霉菌素进行长期治疗后康复。病例二。该患者在口服炔诺孕酮进行周期性治疗后酵母菌被根除；长期阴道用制霉菌素可能起到了辅助作用。病例三。该患者对口服伊曲康唑联合阴道及口服制霉菌素、口服甲羟孕酮或阴道内用硼酸的长期疗程无反应。最终通过局部应用1%龙胆紫实现了光滑念珠菌的根除。在光滑念珠菌感染根除后不久，病例二和病例三均发生了对唑类抗真菌药物敏感的其他念珠菌属感染。
