What are the diagnostic criteria for vulvovaginal candidiasis (VVC) in females?

From the Guidelines

To diagnose a yeast infection in females, a combination of clinical suspicion, microscopy, and molecular testing, such as polymerase chain reaction (PCR), is recommended, as it has high clinical accuracy with a sensitivity of 90.9% and specificity of 94.1% 1.

Diagnosis Approach

When diagnosing a yeast infection, it's essential to consider the following steps:

• Recognize common symptoms such as vaginal itching, burning, redness, swelling, pain during urination or intercourse, and a thick, white, odorless discharge resembling cottage cheese.
• Perform a pelvic examination to assess for signs of vulvar edema, erythema, excoriation, fissures, and a white, thick, curd-like vaginal discharge.
• Use microscopy with saline and 10% potassium hydroxide to demonstrate the presence of yeast or hyphae, although this method has poor sensitivity.
• Consider molecular testing, such as PCR, which has been shown to have high clinical accuracy for diagnosing vulvovaginal candidiasis 1.

Limitations of Current Methods

It's crucial to be aware of the limitations of current diagnostic methods, including:

• Microscopy and clinical diagnosis having poor sensitivity and specificity.
• Yeast cultures taking a minimum of 48-72 hours, leading to a delay in diagnosis and treatment.
• The need for a combination of diagnostic methods to confirm the presence of Candida fungi.

Importance of Accurate Diagnosis

Accurate diagnosis is vital to ensure appropriate treatment and prevent misdiagnosis and unnecessary treatment. A diagnosis of vulvovaginal candidiasis should be confirmed by a combination of clinical suspicion, microscopy, and molecular testing, such as PCR, to ensure high clinical accuracy 1.

From the Research

Diagnosis of Yeast Infection in Females

The diagnosis of yeast infection in females is based on several methods, including:

• Macroscopic examination
• Microscopic examination (KOH preparation) 2
• Culture
• Rarely, Pap test 2

Methods of Diagnosis

The diagnosis is typically performed using a combination of these methods to confirm the presence of Candida albicans or other Candida species.

• Macroscopic examination involves a visual inspection of the vaginal area to look for signs of infection, such as redness, swelling, and discharge.
• Microscopic examination (KOH preparation) involves taking a sample of the discharge and treating it with potassium hydroxide (KOH) to kill bacteria and other cells, making it easier to see the yeast cells under a microscope 2.
• Culture involves taking a sample of the discharge and growing it in a laboratory to confirm the presence of Candida species.
• Pap test, although not typically used for diagnosing yeast infections, may also be used in some cases 2.

Importance of Accurate Diagnosis

Accurate diagnosis is essential to ensure effective treatment and prevent recurrence of the infection.

• It is estimated that 7 out of 10 women suffer from yeast infection at least once in a lifetime, and 4 out of 10 have multiple recurrences 2.
• Therefore, proper diagnosis and treatment are crucial to manage the infection and prevent future occurrences.