ABSTRACT
Candida vulvovaginitis is an important medical problem in the United States and other countries worldwide. Physicians should be concerned about the presence of Candida in the vagina of HIV-infected women who have vaginitis symptoms. Estrogen promotes elevated glycogen production by vaginal epithelial cells, which is the primary nutrient source for Candida. The vaginal microbiota has been reported to resemble that of healthy women with a dominance of the same species of Lactobacilli. The immune defense mechanisms that protect against the conversion of vaginal Candida colonization into a symptomatic infection have been largely inferred from studies on mice and rats. Patients also overestimate their ability to self-diagnose a vaginal Candida infection often led astray by prior inaccurate physician diagnosis. The relationship between colonization with a particular C. albicansclade and the likelihood of development of a symptomatic infection or the effectiveness of a particular treatment regimen remain to be examined.
