title: Chronic fungal vaginitis: the value of cultures.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  A prospective observational study of patients referred with chronic vaginal symptoms was undertaken. In addition to a standard evaluation of symptoms, cultures for yeast were performed on modified Sabouraud agar plates.
  
  
  RESULTS
  Seventy-seven isolates were obtained from 74 patients. A total of 68% were Candida albicans; 32% were other species. The clinical syndromes caused by non-Candida albicans isolates were indistinguishable from Candida albicans infections. Fluconazole gave a short-term mycologic cure in all Candida albicans but only 25% of non-Candida albicans cases (p < 0.001). In non-Candida albicans infections, boric acid suppositories achieved the best mycologic cure rate (85%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University School of Medicine, Philadelphia, PA 19140, USA.
authors.forename: P
authors.initials: P
authors.lastname: Nyirjesy
authors.forename: S M
authors.initials: SM
authors.lastname: Seeney
authors.forename: M H
authors.initials: MH
authors.lastname: Grody
authors.forename: C A
authors.initials: CA
authors.lastname: Jordan
authors.forename: H R
authors.initials: HR
authors.lastname: Buckley
mesh_terms: D002175:Candida / Q000302:isolation & purification*; D002176:Candida albicans / Q000302:isolation & purification; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy / Q000382:microbiology*; D002908:Chronic Disease; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D011446:Prospective Studies; D012008:Recurrence; D012441:Saccharomyces cerevisiae / Q000302:isolation & purification*
chemical_list: D015725:Fluconazole