A 33-year-old female patient complains of white, thick vaginal discharge and severe pruritus of the outer genitalia. On pelvic exam, the vaginal introitus is red and swollen with a thin layer of white exudate
The bimanual exam is normal. A KOH prep is positive for hyphae. These findings are indicative of:
A. Vaginal candidiasis
B. Trichomonas infection
C. Chlamydia
D. Bacterial vaginosis
ANS: A
The discharge associated with yeast vaginitis can be differentiated from other infections by symptomatology and wet prep examination. The discharge is very thick, curdlike, and adheres to the vaginal walls. Intense vulvar itching accompanies the discharge. In most cases, inflammation and swelling around the labia and introitus occur. A high suspicion of yeast can be made on physical examination with a wet prep to confirm the diagnosis of Candida albicans. A 10% KOH (potassium hydroxide) prep is most helpful for visualizing budding yeast and hyphae microscopically.
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