Candida vulvovaginitis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]


The diagnosis of Candida vulvovaginitis is based on the clinical findings, supported by laboratory findings. Laboratory studies done for diagnosis include measurement of the vaginal pH, visualization of hyphae on wet mount/ microscopy, as well as culture.

Laboratory Findings

The laboratory findings consistent with the diagnosis of Candida vulvovaginitis include:[1][2][3]

Approach to patient with Candida Vulvovaginitis

The following is a algorithm for diagnosis and treatment of vulvovaginal candidiasis :

Symptomatic Vaginitis
Whitish discharge adherent to the vaginal walls, excoriations and fissures in the genital area
Perform direct microscopy of the vaginal discharge with saline or 10% KOH
Estimate pH of vaginal discharge
Negative direct microscopy
pH < 4.5
Positive direct microscopy
Send for culture
Consider azole therapy
No culture necessary
pH < 4.5
No excess WBC's
pH > 4.5
Excess WBC's
Start azole therapy
Consider mixed infection

Algorithm adopted from Vulvovaginal candidiasis Lancet 2007; 369: 1961–71[3]



  1. Eckert LO (2006). "Clinical practice. Acute vulvovaginitis". N. Engl. J. Med. 355 (12): 1244–52. doi:10.1056/NEJMcp053720. PMID 16990387.
  2. Mendling W, Brasch J (2012). "Guideline vulvovaginal candidosis (2010) of the German Society for Gynecology and Obstetrics, the Working Group for Infections and Infectimmunology in Gynecology and Obstetrics, the German Society of Dermatology, the Board of German Dermatologists and the German Speaking Mycological Society". Mycoses. 55 Suppl 3: 1–13. doi:10.1111/j.1439-0507.2012.02185.x. PMID 22519657.
  3. 3.0 3.1 Sobel JD (2007). "Vulvovaginal candidosis". Lancet. 369 (9577): 1961–71. doi:10.1016/S0140-6736(07)60917-9. PMID 17560449.
  4. "Public Health Image Library (PHIL)".

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