Pathogenic mechanisms in recurrent genital candidosis in women.

A detailed analysis of the microbiological flora and investigation of the host immune response to Candida albicans was performed on 22 women presenting with a history of recurrent genital candidosis, as defined by at least four clinical episodes, with at least two episodes microbiologically proven, due to C albicans in the preceding 12 months. Disease due to C albicans could occur at low counts (10(2)-10(3)/ml) or very high counts (greater than 10(8)/ml). Immunological investigations indicated that both hypersensitive and anergic states occur, the nature of the host response determining the clinical features noted on presentation. Polymicrobial mixed infections were also noted in six women. Recognition of the nature of the host response is important in understanding the pathogensis of recurrent candidosis and devising effective therapeutic regimes.