A female patient is experiencing intense vaginal itching with a cheesy discharge after using an over-the-counter vaginal cleanser daily for three weeks. Which disorder should the nurse suspect this patient is experiencing?
1. candidiasis
2. syphilis
3. gonorrhea
4. genital herpes
Correct Answer: 1
Candidiasis (moniliasis, or yeast infection) is caused by the organism Candida albicans, which has several strains of different virulence. Candida organisms are part of the normal vaginal environment in up to 50% of women, causing problems only when they multiply rapidly. When factors alter the normal vaginal flora, the organism proliferates, resulting in a yeast infection. The manifestations include an odorless, thick, cheesy vaginal discharge. This is often accompanied by itching and irritation of the vulva and vagina, with dysuria, and dyspareunia. This patient was using an over-the-counter vaginal cleanser that altered the normal flora of the vagina and allowed Candida albicans to overgrow in the vaginal environment. Syphilis is not characterized by discharge. The patient with syphilis may have a painless chancre at the site of inoculation. The discharge of gonorrhea is usually a milky white and there is not any itching present. Genital herpes presents with lesions and pain at the site and is not accompanied by discharge.
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