How is Vaginal Yeast Infection Tested & Diagnosed?
With vaginal yeast infections, the main symptoms that would usually qualify for such are external redness of the genitalia, presence of rash, painful sensations within the area, and swelling of the genitals. In addition to that, the inner part may also manifest a slight swelling, fissures, excoriations, and produce a thick vaginal discharge that resembles the texture of cottage cheese according to the Centers for Disease Control and Prevention. While the discharge could also be watery in certain cases, the diagnosis ultimately boils down to more conclusive tests and would require one either way once the other symptoms match the criteria for a possible Candida infection.
When the following signs and symptoms are observed in a patient, the physician now then proceeds to make their diagnosis based on two factors:
1. When a sample is cultured in the laboratory comes back with a positive result for a yeast species, especially if it is specific to Candida sp., then the doctor could then provide the diagnosis that the patient is indeed experiencing a vaginal yeast infection.
Culture sampling is usually indicated when the patient tests negative for a wet mount test (gram staining and visualization). However, do take note that a positive lab test for Candida without any symptoms or manifestations is not conclusive evidence of a persisting vaginal yeast infection. The body naturally harbors Candida sp., and this could produce a false positive result especially when the patient is asymptomatic at best.
2. When a sample combined with saline and 10% potassium hydroxide (KOH) is gram stained to determine the classification of the microorganism as well as its anatomical and physiological structure, and the results show evidence of a yeast-like structure complete with budding, presence of hyphae or tendril-like structures, and pseudohyphae, then the physician can likewise conclude it to be a yeast infection.
The 10% KOH solution is utilized to improve the image produced through the gram staining process by disrupting the cellular materials that would otherwise be an obstruction upon visualization. This procedure is usually indicated for all women who are found to be qualified based on the signs and symptoms that they have experienced, and when the results come back positive, these individuals should be promptly treated to prevent the infection from progressing any further. On the other hand, if the results come back negative, a culture test is then indicated as there might just be a few discrepancies with how the testing was performed or with the sample that was originally procured.
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Complicated forms of VVC or Vulvovaginal Candidiasis are usually caused by an unusual Candida species – causing various other symptoms that should be approached differently as compared to an uncomplicated VVC condition. As such, vaginal cultures are necessary to narrow down the unusual species, considering non-albicans microorganisms through visualization and thorough examination. Next C. albicans, C. glabrata is another microorganism from this genus that causes the same condition and manifestations. The difference with this microorganism, however, is that, unlike C. albicans, it does not form pseudohyphae and its hyphae are likewise not easily recognized when examined under a microscope.
The test would usually comprise of a pelvic exam wherein your physician would conduct an extraction of your vaginal discharge that will then be used for cell culture testing and microscopic examination. Usually, a microscopic examination is preferred as it is fast, secure, and easy to perform. However, when there an insufficient number of cells to generate a positive or negative result, a culture test will then follow. This procedure, on the one hand, would take a few days for it to grow and develop in a specialized lab. Expect a few days to a few weeks of waiting time if your physician opted for a culture test of your sample.
There are no notable risks for such a procedure as it is a minimally invasive process that only aims to procure a sample of your vaginal discharge. No special precautions and preparations are also necessary for such a test apart from showing up and informing your doctor about everything that they would have to know to make a diagnosis. Be sure to especially tell your physician if you are taking antibiotics as this could cause an overgrowth of yeasts in the body.
Speed of Results
The sample is placed on a slide, then a chemical is added to dissolve the obstructive elements. The technician would then examine the presence of yeast cells and fungal hyphae which are branch-like structures protruding out of a cell.
Used as a primary screening tool as it detects the presence of a fungus but could not necessarily determine the type or species of the fungus.
Calcofluor White Stain
A stain is added to your sample that will then glow under UV light. Could provide better visualization of the fungus.
Detects fungi but could not determine the specific species of the fungus.
Fungal Cell Culture
Your sample is inoculated into a nutrient media that will then grow more copies of the fungi present in your sample.
The primary tool for fungal infection diagnosis. Grown cultures can be used for other tests such as susceptibility testing.
Lab Tests Online. (2021). Fungal Tests. Retrieved from https://labtestsonline.org/tests/fungal-tests
Written by Mark Riegel, MD