Differential Diagnosis for Vaginal Infections with Filamentous Hyphae

• Single Most Likely Diagnosis
  • Candidiasis: This is the most common cause of vaginal infections characterized by filamentous hyphae, typically caused by Candida albicans. The presence of hyphae is a hallmark of this infection, which often presents with itching, burning, and a white, clumpy discharge.
• Other Likely Diagnoses
  • Trichomoniasis: Although less commonly associated with filamentous hyphae, some cases of Trichomonas vaginalis infection may present with similar findings, alongside other symptoms like frothy discharge and vaginal odor.
  • Bacterial Vaginosis (BV): While BV is more commonly associated with a shift in vaginal flora rather than filamentous hyphae, some cases may present with similar symptoms, and the diagnosis should be considered in the differential due to its high prevalence.
• Do Not Miss Diagnoses
  • Invasive Aspergillosis: Although rare in the context of vaginal infections, invasive aspergillosis can present with filamentous hyphae and is a potentially life-threatening condition, especially in immunocompromised patients.
  • Mucormycosis: This rare but serious fungal infection can also present with filamentous hyphae and is known for its aggressive nature and high mortality rate, particularly in diabetic or immunocompromised patients.
• Rare Diagnoses
  • Fusariosis: A rare fungal infection caused by Fusarium species, which can present with filamentous hyphae. It is more commonly associated with immunocompromised patients and can be life-threatening.
  • Scedosporiosis: Caused by Scedosporium species, this is another rare fungal infection that can present with similar findings, typically in immunocompromised individuals or those with significant exposure to contaminated water.