Clinical significance of identifying candida on cervicovaginal (Pap) smears.
This study was undertaken to determine the clinical significance of detecting candida on Pap smear. Clinical information was obtained from a questionnaire sent to the health care provider whenever candida was identified during the study period. Candida was identified in 309 (3.0%) of the 10,370 Pap smears examined. Completed questionnaires were returned on 137 (44.3%) patients. All 137 smears were reviewed. Ninety-nine (72%) patients were asymptomatic, 29 (21%) had symptoms typical of candida infection, and nine (7%) had nonspecific symptoms. Forty-four (32%) patients had been treated for candida during the original clinic visit. After the Pap smear reported candida, 19 (20%) of the 93 nontreated patients were contacted and treated, while 10 (11%) were scheduled for further evaluation. No action was taken on the remaining 64 (69%) patients. There was a significant association between having initial symptoms and receiving immediate treatment (P < 0.001) and undergoing subsequent treatment or further evaluation after the Pap smear report (P < 0.001). Marked inflammation was statistically associated with symptoms (P = 0.014), but the form or number of candida organisms was not. In conclusion, the identification of Candida on Pap smear does not necessarily indicate a symptomatic infection, although the Pap smear results had a direct impact on the treatment of 21% of patients in this study and served as a confirmation for clinical treatment in another 32% who had received such treatment at the time of the original visit.
Department of Pathology, East Tennessee State University, College of Medicine, Johnson City 37614-0568, USA.
M S
MS
Shurbaji
I T
IT
Burja
W L
WL
Sawyer
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D002584:Cervix Uteri / Q000382:microbiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D014621:Vagina / Q000382:microbiology* / Q000473:pathology; D014626:Vaginal Smears