Our purpose was to examine the importance of fungal cultures in evaluating patients with symptoms of chronic vaginitis by assessing the relative contribution of various yeast species and by comparing infections caused by Candida albicans with those caused by other species. In addition to a standard evaluation of symptoms, cultures for yeast were performed on modified Sabouraud agar plates. Seventy-seven isolates were obtained from 74 patients. The clinical syndromes caused by non- Candida albicans isolates were indistinguishable from Candida albicans infections. Because non- Candida albicans species are responsible for a significant number of chronic fungal vaginal infections and are more resistant to therapy with fluconazole, fungal cultures are a valuable aid in confirming the diagnosis and selecting appropriate therapy.
Fungal vaginitis remains one of the most common infections of the female genital tract.
For most of these women these infections are a rare event that responds to a multitude of therapies. 3 Theories to explain these repeated infections have focused on vaginal reinfection, either from a gastrointestinal source or from sexual transmission, or on vaginal relapse, which hypothesizes that recurrent infections are due to the same infecting organism, which is only temporarily suppressed by antifungal therapy. As a result, fungal cultures have not been used by most clinicians to evaluate women with chronic fungal vaginitis. The rationale for this approach is that fungal cultures will be too sensitive, detecting yeast that are colonizing patients but not the cause of symptoms, and that most isolates will be C. albicans. In July 1991 the Temple University Vaginitis Referral Center was established to evaluate and treat women with chronic vaginal symptoms who were referred by private gynecologists.