Which laboratory finding would most support the diagnosis of vulvovaginal candidiasis in a patient with a recent antibiotic course and thick white discharge?

Which laboratory finding would most support the diagnosis of vulvovaginal candidiasis in a patient with a recent antibiotic course and thick white discharge?

• A. Motile Gram-negative rods on Gram stain
• B. Positive whiff test
• C. Yeast cells on microscopy
• D. Clue cells on microscopy

Answer: (C)

Vulvovaginal candidiasis happens when overgrowth of Candida occurs after disruption of the normal vaginal flora, such as from antibiotics. The best lab support is finding Candida organisms—yeast cells, often with pseudohyphae—in the vaginal discharge under microscopy. This direct visualization confirms a fungal etiology and fits the thick, white, cottage-cheese-like discharge commonly described. Other options point to different infections. A positive whiff test is more typical of bacterial vaginosis due to volatile amines. Clue cells seen on microscopy also indicate BV, not Candida. Motile Gram-negative rods would suggest a bacterial pathogen rather than a fungal overgrowth.

Vulvovaginal candidiasis happens when overgrowth of Candida occurs after disruption of the normal vaginal flora, such as from antibiotics. The best lab support is finding Candida organisms—yeast cells, often with pseudohyphae—in the vaginal discharge under microscopy. This direct visualization confirms a fungal etiology and fits the thick, white, cottage-cheese-like discharge commonly described.

Other options point to different infections. A positive whiff test is more typical of bacterial vaginosis due to volatile amines. Clue cells seen on microscopy also indicate BV, not Candida. Motile Gram-negative rods would suggest a bacterial pathogen rather than a fungal overgrowth.