Recurrent Fungal Vulvovaginitis and Its Association with Vaginal Bacterial Colonization

Abstract

Objective: To evaluate the association between recurrent vulvovaginal fungal infections and bacterial colonization in patients referred to a private specialized center. Methods: 198 patients with fungal infections diagnosed by culture, ages 18-72, were evaluated with vaginal bacterial cultures for: Streptococcus, Gonococcus, Chlamydia, Mycoplasma, and Ureaplasma, between January 1995 and July 2002. Results: The symptoms most frequently reported were: itching, 101 patients (52.9%); burning, 72 patients (37.7%); and dyspareunia, 49 patients (25.9%). The most frequent physical findings were: erythema, 108 patients (61.8%); tenderness, 59 patients (30.9%); and discharge, 51 patients (26.7%). The most common fungal cultures were 145 patients (75.9%), Candida albicans; 73 patients (38.2%), Candida stelloidea; and 16 patients (8.4%), Candida glabrata. Bacterial colonization was diagnosed in 83 patients (41.9%). The most common bacterial cultures were Group B Streptococcus, 27 patients (32.8%); Ureaplasma, 15 patients (18.3%); and Enterococcus and Gardnerella, 8 patients each (9.7%). Conclusion: Vaginal bacterial colonization is frequently concomitant (41.9%) with recurrent vulvovaginal fungal infections. A complete set of fungal and bacterial cultures is suggested the evaluation of patients with recurrent fungal vulvovaginitis who are unresponsive to antifungal therapy.