Abstract
Successful treatment of patients with symptoms of vulvovaginitis requires an accurate diagnosis. However, the diagnosis of Candida species by standard office means is often no more accurate than a coin toss. In this clinical study, the usual office techniques (history, examination, and KOH preparation microscopy) were compared with culture on Sabouraud agar for 285 patients with Candida vulvovaginitis and were found to be inadequate (sensitivity of KOH preparation for Candida = 50.8%; positive predictive value 78.0%). Culture for Candida species on Diamond's media modified, a broth medium developed for culture of Trichomonas vaginalis (Remel Regional Media Laboratories), was then compared with culture on Sabouraud CG agar in these patients. Overall agreement between the two tests was 95.1% (sensitivity 90.4%, specificity 99.3%). Ninety-six percent of the erroneous clinical diagnoses (compared with culture on Sabouraud's agar) were corrected with the Diamond's media culture. Culture for Candida species with Diamond's media is technically simple and offers an economical means of clarifying the diagnosis of vulvovaginal candidiasis while also culturing T. vaginalis in the primary care office setting.
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