CULTURE AND WET SMEAR MICROSCOPY IN THE DIAGNOSIS OF LOW-SYMPTOMATIC VULVO-VAGINAL CANDIDOSIS

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.