Self-reported yeast symptoms compared with clinical wet mount analysis and vaginal yeast culture in a specialty clinic setting.
OBJECTIVE
To determine the validity of patients' self-reported symptoms of vulvovaginal candidiasis and the accuracy of clinical wet mount examinations compared with vulvovaginal yeast culture results in a specialty clinic.


METHODS
A retrospective chart review of new patients seen at the Saint Louis University Vulvar and Vaginal Disease Clinic from January 2005 to March 2006 was performed. Patients' age, medication use, symptom scores on a rating scale for vaginal/vulvar pain, burning, itching, dyspareunia and wet mount analyses were compared with yeast culture results.


RESULTS
Of 153 patients, 40 had positive yeast cultures (prevalence rate 26.1%). Compared with yeast cultures, self-reported symptom scores >4 resulted in high sensitivity (90%) and low specificity (7%). Positive wet mount result showed low sensitivity (18%) and high specificity (99%). Patient symptom scores were a poor predictor of yeast infections based on yeast culture results. No correlation was found among wet mount, self-reported symptoms and yeast culture results. No significant difference between age or symptom scores to culture result was found.


CONCLUSIONS
Wet mount analysis for recurrent or persistent patient symptoms should be reevaluated. Self-reported symptoms are not reliable for diagnosis. Wet mount analysis resulted in low sensitivity. Yeast cultures should be considered the gold standard for identification of vulvovaginal candidiasis in persistent or recurrent cases.
Hoffstetter
Susan E
SE
Department of Obstetrics, Gynecology, and Women's Health, School of Public Health, Saint Louis University, St. Louis, MO 63117, USA. hoffstes@slu.edu
Barr
Susan
S
LeFevre
Cherie
C
Leong
Fah Che
FC
Leet
Terry
T
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D002181:Candidiasis, Vulvovaginal / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012647:Self-Assessment