J Low Genit Tract Dis. 2022 Jan 01;26(1):68-70. doi: 10.1097/LGT.0000000000000641.
Mixed Vaginitis Due to Bacterial Vaginosis and Candidiasis.
Journal of lower genital tract disease
Dana Benyas, Jack D Sobel
Affiliations
Affiliations
- Department of Internal Medicine, Wayne State University School of Medicine Detroit, MI.
PMID: 34840242
DOI: 10.1097/LGT.0000000000000641
Abstract
OBJECTIVE: The aim of the study was to review recent clinic cases with mixed vaginitis due to bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) with reference to demographics, clinical presentation, diagnosis, and treatment.
MATERIALS AND METHODS: This is a retrospective chart review of patients defined with mixed vaginitis due to BV and VVC in academic vaginitis clinic over 3 years (2018-2021).
RESULTS: Thirty-eight women, mean age 32.6 years, met mixed vaginitis definition criteria. Diagnosis was invariably suspected clinically and rapidly confirmed using standard point of care diagnostic tests. Most patients (>90%) had a history of long-standing recurrent vaginitis both BV and VVC. Condom use was infrequent at 30% and 100% of yeast isolates were Candida albicans. Dual antimicrobial therapy achieved short term therapeutic success in 66.7% with failure in part due to fluconazole resistant C. albicans strains.
CONCLUSIONS: Mixed vaginitis is not uncommon and serves as a significant therapeutic challenge requiring initial dual antimicrobial therapy and additional consideration for long-term antimicrobial therapy.
Copyright © 2021, ASCCP.
Conflict of interest statement
The authors have declared they have no conflicts of interest.
References
- Foxman B, Marsh JV, Gillespie B, et al. Frequency and response to vaginal symptoms among White and African American women: results of a random digit dialing survey. J Womens Health 1998;7:1167–74. - PubMed
- Rivers CA, Adaramola OO, Schwebke JR. Prevalence of bacterial vaginosis and vulvovaginal candidiasis mixed infection in a southeastern American STD clinic. Sex Transm Dis 2011;38:672–4. - PubMed
- Sobel JD, Subramanian C, Foxman B, et al. Mixed vaginitis—more than coinfection and with therapeutic implications. Curr Infect Dis Rep 2013;15:104–8. - PubMed
- Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep 2021;70:1–187. - PubMed
- Clinical and Laboratory Standards Institute 2017. Reference Method for Both Dilution Antifungal Susceptibility Testing of Yeasts; Approved Standard, Third Edition. CKSI Document M27-A4. Wayne, PA: Clinical and Laboratory Institute. - PubMed
- Redondo-Lopez V, Meriwether C, Schmitt C, et al. Vulvovaginal candidiasis complicating recurrent bacterial vaginosis. Sex Transm Dis 1990;17:51–3. - PubMed
- Vahidnia A, Tuin H, Bliekendaal H, et al. Association of sexually transmitted infections, Candida species, gram-positive flora and perianal flora with bacterial vaginosis. New Microbiol 2015;38:559–63. - PubMed
- Marchaim D, Lemanek L, Bheemreddy S, et al. Fluconazole-resistant Candida albicans vulvovaginitis. Obstet Gynecol 2012;120:1407–14. - PubMed
- Surapaneni S, Akins R, Sobel JD. Recurrent bacterial vaginosis: an unmet therapeutic challenge. Experience with a combination pharmacotherapy long-term suppressive regimen. Sex Trans Dis 2021;48:761–5. - PubMed
- Marrazzo JM, Dombrowski JC, Wierzbicki MR, et al. Safety and efficacy of a novel vaginal anti-infective, TOL-463, in the treatment of bacterial vaginosis and vulvovaginal candidiasis: a randomized, single-blind, phase 2, controlled trial. Clin Infect Dis 2019;68:803–9. - PubMed
Publication Types
