Quantitative system for diagnosis of vulvovaginal candidiasis

J Mycol Med. 2022 Nov;32(4):101302. doi: 10.1016/j.mycmed.2022.101302. Epub 2022 Jun 9.

Abstract

Introduction: Vaginal infections are one of the most common reason for gynecological consultations. Many of them are the result of overgrowth of resident microorganisms. The clinical symptoms of vulvovaginal candidiasis are nonspecific and an accurate diagnosis is a problem that often leads to inadequate treatment or delays in treatment. The lack of an exact and practical diagnostic method is a common cause of misdiagnosis.

Aim: To create a complex, quantitative method for the diagnosis of vulvovaginal candidiasis which to enables differentiation from vaginal fungal colonization.

Material and methods: A total of 2306 vaginal samples were examined. Clinical, microbiological, epidemiological methods and statistical models are used.

Results and discussion: The proposed score system is a specific, sensitive and inexpensive method to routinely diagnose vulvovaginal candidiasis. Statistical processing of the obtained data shows the impact of the individual components on which the method is based: the presence of vaginal discharge, pruritus, direct microscopy and assessment of the fungal growth. The data analysis reveals good sensitivity (71%) and high specificity (98%) of the method. This allows accurate interpretation of the result of the clinical and microbiological examination of each patient.

Conclusion: The system for diagnosing vulvovaginal candidiasis is complex and based on quantitative indicators. The method can be used to differentiate vulvovaginal candidiasis from vaginal fungal colonization (the cut-off value is 5.5 points) and to more accurately interpret a Candida positive result from quantitative real-time PCR in asymptomatic patients or in women with mixed vaginal infection.

Keywords: diagnosis; vaginal infection; vulvovaginal candidiasis.

MeSH terms

  • Candida
  • Candidiasis, Vulvovaginal* / microbiology
  • Female
  • Humans
  • Vagina / microbiology