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Erschienen in: Die Gynäkologie 10/2020

24.09.2020 | Kontrazeption | Frauengesundheit in der Praxis

Update Vaginalmykose

verfasst von: Prof. Dr. med. Herbert Hof

Erschienen in: Die Gynäkologie | Ausgabe 10/2020

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Zusammenfassung

Eine Besiedlung der Scheide mit Candida (C.) spp. hat nicht in allen Fällen eine entzündliche Infektion zur Folge. Die häufigsten Erreger sind C. albicans gefolgt von C. glabrata. Die Pathogenese hängt nicht nur von der Virulenz der Pilze ab, sondern auch von der individuellen Prädisposition und der Infektabwehr. Frauen im gebärfähigen Alter, speziell bei hormoneller Kontrazeption und bei Schwangerschaft, sind besonders gefährdet, weil die Östrogene die lokalen Verhältnisse verändern, sodass Candida sich besser vermehren kann, und zusätzlich, weil der Pilz selbst Östrogenrezeptoren besitzt, sodass er unter dem Einfluss von Östrogen virulenter wird. Von eminenter Bedeutung ist die unspezifische Infektabwehr der Scheide. Die humorale Immunität dagegen spielt eine untergeordnete Rolle bei der Infektabwehr; die zelluläre Infektabwehr ist entscheidend beteiligt, wobei jedoch das genaue Zusammenspiel nach wie vor noch ziemlich unverstanden ist. Zur antimikrobiellen Therapie gibt es verschiedene topische Antiseptika und Antimykotika. Daneben können aber auch systemisch wirksame Antimykotika, wie z. B. Fluconazol, erfolgreich eingesetzt werden. Bei einer rezidivierenden Vaginalmykose erweist sich in vielen Fällen eine Sekundärprophylaxe mit Fluconazol sinnvoll.
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Metadaten
Titel
Update Vaginalmykose
verfasst von
Prof. Dr. med. Herbert Hof
Publikationsdatum
24.09.2020
Verlag
Springer Medizin
Erschienen in
Die Gynäkologie / Ausgabe 10/2020
Print ISSN: 2731-7102
Elektronische ISSN: 2731-7110
DOI
https://doi.org/10.1007/s00129-020-04664-6

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