B. Zdolsek et al., CULTURE AND WET SMEAR MICROSCOPY IN THE DIAGNOSIS OF LOW-SYMPTOMATIC VULVO-VAGINAL CANDIDOSIS, European journal of obstetrics, gynecology, and reproductive biology, 58(1), 1995, pp. 47-51
Objectives: To compare the clinical usefulness of culture and wet smea
r microscopy in low-symptomatic vulvovaginal candidosis (VVC) diagnosi
s. Study design: Women attending for contraceptive advice were screene
d for vaginal yeast fungi by culture and wet smear microscopy. A posit
ive culture was found in 130 (13.2%) of the 983 women studied, while a
positive wet smear was found in 133 (13.9%). In 40 (30%) of these wom
en both the culture and wet smear was positive. Results: The methods w
ere equally sensitive in predicting symptoms of VVC, such as pruritus,
smarting and burning pain, as well as for dyspareunia (35% vs. 36%),
but wet smear microscopy was more sensitive in predicting signs of VVC
, such as erythema and abnormal discharge (52% vs. 34%). The highest s
ensitivity was reached when both methods were positive (60% for sympto
ms, 75% for signs). There was no quantative correlation between number
of Candida colonies on culture on the one hand and symptoms, signs or
a positive wet smear on the other hand. Using four parameters as a di
agnostic battery for VVC, the two methods complemented each other. The
correlation between symptoms and/or signs for wet smear was higher th
an for culture. Conclusion: Wet smear microcopy of vaginal secretion,
along with signs found at examination, should be the first-line test i
n the diagnosis of VVC, Culture must, however, be used when there is a
clinical suspicion of VVC and a negative wet smear, or when speciatio
n or antibiotic susceptibility tests of isolates are required.