Candida vulvovaginitis laboratory findings

Candida vulvovaginitis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Candidiasis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT
Other Imagining Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Candida vulvovaginitis laboratory findings On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Candida vulvovaginitis laboratory findings All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Candida vulvovaginitis laboratory findings
CDC on Candida vulvovaginitis laboratory findings
Candida vulvovaginitis laboratory findings in the news
Blogs on Candida vulvovaginitis laboratory findings
Directions to Hospitals Treating Candidiasis
Risk calculators and risk factors for Candida vulvovaginitis laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]

Overview

The diagnosis of Candida vulvovaginitis is based on the clinical findings, supported by laboratory findings. Laboratory studies done for diagnosis include measurement of the vaginal pH, visualization of hyphae on wet mount/ microscopy, as well as culture.

Laboratory Findings

The laboratory findings consistent with the diagnosis of Candida vulvovaginitis include:

• Vaginal pH: vaginal pH is normal (ranges from 4.0-4.5)
• Wet mount or Saline preparation: It will help in detection of hyphae, clue cells and motile trichomonas differentiating different causes of vaginitis.
• 10% Potassium hydroxide preparation: It is more sensitive than wet mount to demonstrate budding blastospores or pseudohyphae.
• Culture: Culture for diagnosing candida vulvovaginitis not recommended in patients with positive microscopy. However, it should be done in a symptomatic woman with a negative microscopy and a normal vaginal pH. Culture using Sabouraud agar, Nickerson’s medium, or Microstix-Candida medium identify candida species with equal sensitivity.

Approach to patient with Candida Vulvovaginitis

The following is a algorithm for diagnosis and treatment of vulvovaginal candidiasis :

Symptomatic Vaginitis

Whitish discharge adherent to the vaginal walls, excoriations and fissures in the genital area

Perform direct microscopy of the vaginal discharge with saline or 10% KOH Estimate pH of vaginal discharge

Negative direct microscopy pH < 4.5

Positive direct microscopy

Send for culture Consider azole therapy

No culture necessary

pH < 4.5 No excess WBC's

pH > 4.5 Excess WBC's

Start azole therapy

Consider mixed infection

Algorithm adopted from Vulvovaginal candidiasis Lancet 2007; 369: 1961–71

Gallery

• 

  Wet mounted vaginal smear specimen, revealed the presence of Candida albicans, which had been extracted from a patient with vaginal candidiasis. From Public Health Image Library (PHIL).