Vulvovaginal candidiasis refractory to treatment with fluconazole

Chronic vulvovaginal candidiasis: characteristics of women with Candida albicans, C glabrata and no candida.

“…The higher proportion of false-negative C glabrata cases may be due to the lack of hyphae formation by this organism, making it more difficult to identify microscopically.2526 Speciation of positive yeast cultures allowed us to differentiate C albicans and C glabrata VVC; speciation also facilitates the tailoring of therapeutics to the organism. [13][14][15][16][17][18][19][20] Our study was limited in size and has all the problems inherent in medical record review studies. Further, the study population is susceptible to selection bias due to complex, undefined referral patterns in the broader population; this may limit the generalisability of our results to women attending similar clinics and may create false associations in our comparisons.…”

Resistance of Candida species to fluconazole

“…When they were tested, fluconazole MICs for organisms isolated serially from patients with persistent candidemia did not show rises (66). Other settings in which patients have failed to respond to fluconazole therapy include C. albicans colonization with persistent fever (two patients) (80), C. albicans sternal osteomyelitis (one patient) (25), vaginal candidiasis caused by C. glabrata (two patients) (7,87), hepatosplenic infection caused by Candida species (one patient) (29), urinary tract infection in a mechanically ventilated patient colonized with C. glabrata (40), and C. glabrata funguria in a patient with hepatorenal failure (86). Because of the limited numbers of cases, it is difficult to make generalizations about the reasons for failure in these cases.…”

Candida G lab rata Chorioamnionitis Following In Vitro Fertilization and Embryo Transfer

“…In our opinion, vaginal and in particular cervical swabs should be taken prior to insertion of any cannula into the uterus for embryo transfer. If any pathogens are detected, then the procedure should be deferred until treatment has been instituted and the micro-organism eradicated ( 12). If Candida glabrata is found within the lower genital tract, a protracted course of treatment may be necessary as this fungus has been found to be unresponsive to both local imidazole derivatives and also to systemic treatment modalities (13).…”