Pathogenesis of recurrent vulvovaginal candidiasis

Recurrent vulvovaginal candidiasis (RVVC) is by no means uncommon and is a source of considerable physical suffering, in addition to serving as a major therapeutic challenge. The syndrome is multifactorial in etiology, hence management strategies must recognize the complex etiologic pathways. Considerable progress has been made in identifying secondary causes, including biologic and host factors. Specifically, Candida microbiologic studies have revealed that azole resistance in Candida albicans is rare and infection by less sensitive non-albicans Candida species is uncommon. At least half the women with RVVC have no identifiable host or microbial predisposing factors, and an immune-based hypothesis has been generated.