Vaginal Candidiasis, Diabetes

Discharged 2

Step 1: View clinicals

A 42 year old woman presents with a vaginal discharge for 4 weeks associated with pruritus and external dysuria. She also complains of superficial dyspareunia of recent onset. She was diagnosed with type 2 diabetes mellitus 2 years ago and is currently on maximum doses of oral metformin and glipizide. A HbA1c performed last week is 10.4%, while her postprandial plasma glucose is 320 mg/dl after 2h.


Step 2: Order all relevant investigations

10% KOH smear

The 10% KOH smear of the discharge shows multiple pseudohyphae and blastospores. There is no amine odor.

Culture for Candida spp

Cultures are positive for Candida albicans.

Culture for T. vaginalis

Cultures are negative for Trichomonas.

GC/CT NAAT

Negative for Chlamydia Negative for Gonorrhea


Step 3: Select appropriate management

Avoid sexual intercourse
Treat partner
Intravaginal Clotrimazole
Oral Metronidazole


Score: ★★☆