How useful are symptoms in the diagnosis of Candida vaginitis?

Two hundred four female subjects symptomatic and asymptomatic for genitourinary disease were evaluated for Candida vaginitis. All were questioned regarding the presence or absence of a variety of symptoms related to the genitourinary system, including vaginal discharge, its color, if present, pruritus, dysuria, and the like. Additionally, all subjects were cultured for Candida by use of Sabouraud agar. Thirty-six subjects demonstrated cultures positive for Candida. Of 36 totally asymptomatic subjects, 4 had positive cultures, yielding a prevalence (18 percent) and asymptomatic positive rate (11 percent) consistent with those reported in the literature. All genitourinary symptoms individually and in combinations proved to be very poor predictors of the presence of Candida on culture. The study concludes that the diagnosis of Candida vaginitis cannot be made based on symptoms alone. A suggestion describing the office workup of Candida vaginitis is presented.