Vulvovaginal Candida: a study of (a)symptomatic women
The research described in this thesis concerns presence of asymptomatic vaginal Candida and vulvovaginal candidiasis. Vulvovaginal candidiasis (VVC) is an infection caused by abnormal growth of yeasts in the mucosa of the female genital tract. Acute vulvar pruritus and vaginal discharge are the usual presenting complaints, and vulvovaginal examination frequently reveals epithelial erythema and swelling of the labia and vulva together with adherent whitish discharge. However, due to lack of specificity of signs and symptoms, all patients with symptomatic vaginitis should be diagnosed on the bas... Mehr ...
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Dokumenttyp: | Dissertation |
Erscheinungsdatum: | 2007 |
Verlag/Hrsg.: |
Utrecht University
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Schlagwörter: | Geneeskunde / vulvovaginal / Candida / candidiasis / cervix / cancer / GP / Dutch / microscopy / dysbacteriosis |
Sprache: | Englisch |
Permalink: | https://search.fid-benelux.de/Record/base-27066791 |
Datenquelle: | BASE; Originalkatalog |
Powered By: | BASE |
Link(s) : | https://dspace.library.uu.nl/handle/1874/21528 |
The research described in this thesis concerns presence of asymptomatic vaginal Candida and vulvovaginal candidiasis. Vulvovaginal candidiasis (VVC) is an infection caused by abnormal growth of yeasts in the mucosa of the female genital tract. Acute vulvar pruritus and vaginal discharge are the usual presenting complaints, and vulvovaginal examination frequently reveals epithelial erythema and swelling of the labia and vulva together with adherent whitish discharge. However, due to lack of specificity of signs and symptoms, all patients with symptomatic vaginitis should be diagnosed on the basis of microscopic examination of their vaginal secretions. In the first chapters of this thesis, we examined how general practitioners (GPs) in The Netherlands diagnose and treat vaginal candidiasis, by sending questionnaires to 1160 Dutch GPs and by checking the microscopy performed by 324 Dutch GPs on stained vaginal smears of patients with symptomatic vaginitis. The questionnaires revealed that only 61 (16.1%) Dutch GPs always or often performs microscopy when diagnosing candidiasis, while 143 (37.6%) GPs never use a microscope to confirm their diagnosis. In addition, sensitivity and specificity of the microscopic diagnoses of the clinicians was only 52% and 89% respectively. This suggests that GPs often diagnose 'vulvovaginal candidiasis' in their practices, without (adequately) performing the laboratory examinations required to confirm their putative diagnosis, which could lead to wrong diagnoses and maltreatment. However, Candida (pseudo)hyphae and/or blastospores are also often discovered in cervical smears of asymptomatic women during their childbearing years. Since 1996 all women in the Netherlands between the ages of 30 and 60 receive an invitation once every five years to have a cervical smear taken. These smears are coded according to the Dutch national coding system for cervical cytology (KOPAC). KOPAC is an acronym, in which the O-category stands for ontsteking (inflammation) and the P-category reflects the ...