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Neither History Nor Clinical Exam Help Identify Positive Vaginal Candida Infection

Among women with recurrent vulvovaginal candidosis, neither history nor findings at a clinical examination can distinguish between women who will have a positive culture from those who will have a negative culture for Candida, Swedish investigators have found.

Clinicians at the Department of Obstetrics and Gynecology, University Hospital, Lund, Sweden, used 32 parameters and 10 signs found at clinical examination in interviews with 83 women with a history consistent with recurrent vulvovaginal candidosis (RVVC). Candida cultures were taken from the introitus and the posterior vaginal fornix.

Most of the many etiological factors which are associated with RVVC could be traced only in a few of the 43 women who had a positive yeast culture and the 40 women who had a negative yeast culture.

There were only two areas in which the cohort differed: intake of yogurt and vaginal douching. Yogurt intake was reported by 28 women (68 percent) with a positive Candida culture, and 38 women (95 percent) with a negative Candida culture. Vaginal douching was carried out by 10 women (23 percent ) in the Candida positive group, and by 17 women (42 percent) in the Candida negative group.

Pruritis was found in 31 women (72 percent), and burning in 22 women (51 percent), among those who were Candida positive. These symptoms were not as frequent in the Candid negative group, with 19 women (47 percent) having pruritis and 9 women (22 percent) having burning.

Edema of the vulva, as well as erythema, edema of the vaginal mucosa and caseous discharge, were found more often in the Candida positive women.
Acta Obstet Gynecol Scand 2002; Nov;81(11):1047-52. "Characterization of women with a history of recurrent vulvovaginal candidosis."

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