From the Guidelines
To assess recurrent chronic yeast infections, clinicians should ask about the frequency and duration of episodes, previous treatments tried and their effectiveness, symptom patterns, and potential risk factors, as outlined in the 2016 clinical practice guideline for the management of candidiasis by the Infectious Diseases Society of America 1. When evaluating a patient with suspected recurrent chronic yeast infections, it is essential to inquire about the number of infections in the past year, with four or more episodes suggesting recurrent infection, as defined by the 2016 guideline 1. Some key points to consider when taking a history include:
- The symptoms experienced, such as itching, burning, and discharge characteristics, to help distinguish yeast infections from other conditions with similar symptoms 1
- Previous antifungal treatments used, including prescription and over-the-counter medications, to assess their effectiveness and potential resistance 1
- Medication adherence and whether symptoms fully resolved between episodes, to identify potential issues with treatment compliance or recurrence 1
- Important risk factors, such as recent antibiotic use, uncontrolled diabetes, immunosuppressive conditions or medications, hormonal contraceptive use, and menopause status, which can contribute to the development of recurrent yeast infections 1
- Sexual history, including new partners, condom use, and partner symptoms, as yeast infections can be transmitted through sexual contact 1
- Hygiene practices, such as douching, use of scented products, tight clothing, and synthetic underwear, which can increase the risk of yeast infections 1
- Dietary habits, particularly sugar consumption, which may contribute to recurrence, although the evidence for this is limited 1 By asking these questions, clinicians can identify modifiable risk factors and guide treatment and prevention strategies for patients with recurrent chronic yeast infections, ultimately improving morbidity, mortality, and quality of life outcomes.
From the Research
History Questions for Recurrent Chronic Yeast Infections
To assess recurrent chronic yeast infections, the following history questions are necessary:
- What are the patient's symptoms, and how long have they been experiencing them? 2, 3
- Has the patient been previously diagnosed with a yeast infection, and if so, how many times? 2, 3
- What treatments has the patient tried in the past for yeast infections, and were they effective? 2, 4, 3
- Does the patient have any underlying medical conditions, such as diabetes or a weakened immune system, that may be contributing to the recurrent infections? 2, 5
- Is the patient taking any medications, such as antibiotics or steroids, that may be increasing their risk of developing yeast infections? 2, 5
- What are the patient's hygiene and sexual practices, and could these be contributing to the recurrent infections? 5, 3
- Has the patient been tested for other infections, such as trichomoniasis, that may be causing their symptoms? 5
Additional Considerations
When assessing recurrent chronic yeast infections, it is also important to consider the following:
- The patient's history of antifungal use and potential resistance to certain treatments 2, 4
- The patient's lifestyle and environmental factors that may be contributing to the recurrent infections 5, 3
- The need for further testing or evaluation to determine the underlying cause of the recurrent infections 2, 4, 5, 3