Abstract
Vulvovaginitis is common in diabetic women and is often treated with antifungal agents on the assumption that the causative organism is Candida albicans. In a survey of 100 consecutive diabetic women attending a diabetes clinic 36 had complained to their general practitioner about vulvovaginal irritation during the past three years and 26 were treated with antifungal agents without a vaginal examination or swabs being taken. In a separate study 27 post-menopausal women with non-insulin dependent diabetes and symptoms of vulvovaginitis were investigated. The organisms cultured were: Candida albicans (n = 6), beta haemolytic streptococci (n = 14), Gardnerella vaginalis (n = 2), Staphylococcus aureus (n = 2), Streptococcus milleri (n = 1), Streptococcus faecalis (n = 1), Klebsiella oxytoca (n = 1), no organisms (n = 3). Where a bacterial organism was isolated symptoms resolved in all but one case with appropriate antibiotic treatment. It is recommended that the practice of initiating antifungal treatment without taking high vaginal swabs should be reviewed and treatment should be given specifically rather than empirically.
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Selected References
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- Anthony B. F., Eisenstadt R., Carter J., Kim K. S., Hobel C. J. Genital and intestinal carriage of group B streptococci during pregnancy. J Infect Dis. 1981 Jun;143(6):761–766. doi: 10.1093/infdis/143.6.761. [DOI] [PubMed] [Google Scholar]
- Bagdade J. D., Root R. K., Bulger R. J. Impaired leukocyte function in patients with poorly controlled diabetes. Diabetes. 1974 Jan;23(1):9–15. doi: 10.2337/diab.23.1.9. [DOI] [PubMed] [Google Scholar]
- Baker C. J., Goroff D. K., Alpert S., Crockett V. A., Zinner S. H., Evrard J. R., Rosner B., McCormack W. M. Vaginal colonization with group B streptococcus: a study in college women. J Infect Dis. 1977 Mar;135(3):392–397. doi: 10.1093/infdis/135.3.392. [DOI] [PubMed] [Google Scholar]
- De Costa E. J. Infections of the vagina and vulva. Clin Obstet Gynecol. 1969 Mar;12(1):198–218. doi: 10.1097/00003081-196903000-00011. [DOI] [PubMed] [Google Scholar]
- Eschenbach D. A. Vaginal infection. Clin Obstet Gynecol. 1983 Mar;26(1):186–202. doi: 10.1097/00003081-198303000-00023. [DOI] [PubMed] [Google Scholar]
- Sobel J. D. Epidemiology and pathogenesis of recurrent vulvovaginal candidiasis. Am J Obstet Gynecol. 1985 Aug 1;152(7 Pt 2):924–935. doi: 10.1016/s0002-9378(85)80003-x. [DOI] [PubMed] [Google Scholar]