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Infectious Diseases in Obstetrics and Gynecology
Volume 13, Issue 1, Pages 37-41
http://dx.doi.org/10.1155/2005/401530

Vaginal Candida parapsilosis: Pathogen or Bystander?

1Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, PA, USA
2Department of Obstetrics and Gynecology, Jefferson Medical College, Philadelphia, PA, USA
3New College Building, 245 N. 15th Street, Philadelphia, PA 19102, USA

Copyright © 2005 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: Candida parapsilosis is an infrequent isolate on vaginal cultures; its role as a vaginal pathogen remains unstudied. This retrospective study of women with positive culture for C. parapsilosis sought to characterize the significance of this finding and its response to antifungal therapy.

Methods: From February 2001 to August 2002, we identified all individuals with positive fungal isolates among a population of women with chronic vulvovaginal symptoms. Charts of women with C. parapsilosis cultures were reviewed with regard to patient demographics, clinical presentation and therapeutic response. Mycological cure, defined as a negative fungal culture at the next office visit, and clinical cure, i.e. symptom resolution, were determined for each subject.

Results: A total of 582 women had positive vaginal cultures for 635 isolates, of which 54 (8.5%) were C. parapsilosis. The charts of 51 subjects with C. parapsilosis were available for review and follow-up cultures and clinical information were available for 39 (76.5%). Microscopy was positive in 9 (17.6%). Antifungal treatment resulted in mycological cure in 17/19 patients with fluconazole, 7/7 with butoconazole, 6/6 with boric acid, 1/1 with miconazole and occurred spontaneously in 6/ 7: 24/37 (64.9%) patients with a mycological cure experienced clinical cure.

Conclusions: Although C. parapsilosis is often a cause of vaginal symptoms, it seems to respond to a variety of antifungal agents and may even be a transient vaginal colonizer.