Vaginal Candidiasis

For 3 days, a 23-year-old woman had been bothered by pruritic vaginal and vulvar lesions. A cheesy white vaginal discharge was associated with the itching.

She denied being sexually active. Her medical history was significant only for antibiotic therapy for sinusitis a few weeks earlier. She had no allergies.

The patient was afebrile. Whitish, nonmalodorous plaques were noted on the labia and other areas of the vulva. Microscopic examination of scrapings from the lesions revealed hyphal elements and spores. A diagnosis of candidiasis was confirmed.

Gopi Rana-Mukkavilli, MD of New York City writes that vaginal candidiasis is very common and may recur as often as several times a year. Diabetes, as well as HIV infection and other immunosuppressive diseases, heightens the risk of candidal infection. Antibiotic therapy also predisposes patients to vaginal yeast infections. Antifungal creams and vaginal suppositories, as well as oral fluconazole, can eradicate the fungus.

This patient was given a single dose of fluconazole, 150 mg. No signs or symptoms of a yeast infection were noted on follow-up.