National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention
Division of Sexually Transmitted Diseases
Program and Training Branch
Most patients with symptomatic VVC can be readily diagnosed on the basis of a microscopic examination of vaginal secretions. Visualization of pseudohyphae (mycelic) and/or budding yeast (conidia) on 10% KOH wet prep examination, saline wet mount, or Gram stain can solidify the diagnosis of VVC.
The vaginal pH in VVC is normal (4.0 to 4.5). If the pH is abnormally high (> 4.5), it usually indicates a concurrent bacterial vaginosis or trichomoniasis. Large numbers of white blood cells are usually absent and, if present, indicate a concurrent or mixed infection.
Cultures are not useful for routine diagnosis of VVC since positive cultures may detect colonization rather than clinically significant infections. However, cultures may be useful to detect non-albicans species or resistant organisms in women with recurrent disease.