Diagnostic Testing

• Microscopic investigation for the presence of blastospores or pseudohyphae; saline wet mount has a sensitivity of 40% to 50%, while a KOH preparation has a

sensitivity of 50% to 70%. Asymptomatic vaginal colonization of Candida albicans is not diagnostic of VVC since 10% to 20% of women are asymptomatic carriers of Candida species. Asymptomatic vaginal colonization does not require treatment; therefore the presence alone of Candida should not determine care.

• Vaginal pH less than or equal to 4.5; pH should remain normal in cases of fungal infection, while an elevated pH suggests bacterial infection.

• Candida cultures should be obtained only if signs and microscopy are inconclusive or in cases of recurrent VVC.

Table 83-1 Possible Risk Factors Associated With VVC

Risk Factor

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