A vulvovaginal yeast infection caused by several types of Candida . This disease is common in all women, but may occur more frequently and severely in immunocompromised women. Physical exam of external genitalia may reveal an inflamed vulva with evidence of the discharge on labial folds and vaginal opening. Speculum exam usually reveals a white, thick discharge with plaques adhering to the vaginal walls and cervix. Bimanual exam should be normal, and should not elicit pain or tenderness if this is an uncomplicated yeast infection.
Definitive diagnosis is made by culture of vaginal secretions.
In the presence of urinary tract symptoms, get clean-catch specimen, perform culture and sensitivity studies. These creams may also be used on vulva for pruritus. Alternatively, fluconazole 150 mg po, single dose, may be used. Discuss an alternative contraceptive method to oral contraceptives if that is patient's current method. Monitor liver function tests.