Can an Ovarian Cyst Become Infected by Vaginal Candida Glabrata?
No, a vaginal Candida glabrata infection cannot directly infect an ovarian cyst in immunocompetent women, as this organism remains confined to mucosal surfaces and does not ascend to cause upper genital tract disease under normal circumstances. 1
Why Vaginal Candida Does Not Typically Cause Ovarian Cyst Infection
Candida glabrata remains confined to vaginal and vulvar mucosal surfaces in immunocompetent women and does not have the pathogenic mechanisms to ascend through the cervix and upper genital tract like sexually transmitted pathogens. 1
Upper genital tract infections (pelvic inflammatory disease) are caused by specific pathogens including Chlamydia trachomatis, Neisseria gonorrhoeae, and bacterial vaginosis-associated organisms—not by Candida species. 2
The characteristic presentation of C. glabrata vulvovaginitis includes white adherent vaginal discharge, burning, itching, vulvar edema, erythema, excoriation, and fissures, all confined to the lower genital tract. 1
The Rare Exception: A Single Case Report
Only one documented case exists of a tuboovarian abscess associated with Candida glabrata, occurring in a 47-year-old woman with an intrauterine device (IUD). 3
This case required removal of the abscess and treatment with amphotericin B, suggesting this was an extremely unusual event facilitated by the presence of a foreign body (IUD) that likely provided a direct pathway for ascending infection. 3
The rarity of this single case report from 1995, with no subsequent similar cases in the literature, underscores that this is not a typical pattern of C. glabrata infection. 3
Critical Distinction for Immunocompromised Patients
In severely immunocompromised patients only, C. glabrata vaginal colonization combined with systemic symptoms (high fever, poor general condition) warrants urgent evaluation for disseminated candidiasis, which represents a life-threatening emergency requiring blood cultures and systemic antifungal therapy with echinocandins. 1
This disseminated disease is fundamentally different from local ascension to an ovarian cyst—it represents hematogenous spread throughout the body, not direct extension from the vagina. 1
Clinical Bottom Line
If you have an ovarian cyst and vaginal C. glabrata infection, treat the vaginal infection with intravaginal boric acid 600 mg daily for 14 days as first-line therapy. 4
Any pelvic pain, fever, or systemic symptoms should prompt evaluation for other causes of upper genital tract infection (bacterial PID) or ovarian cyst complications (rupture, torsion), not Candida infection of the cyst. 2
The presence of an IUD is the only documented risk factor for potential (though still extraordinarily rare) upper tract Candida infection. 3