For 3 days,
a 23-yearold
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.
Dr Gopi Rana-Mukkavilli 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.