Infectious Diseases in Obstetrics and Gynecology

Infectious Diseases in Obstetrics and Gynecology / 2000 / Article

Open Access

Volume 8 |Article ID 907480 |

Stephanie Weissenbacher, Steven S. Witkin, Vera Tolbert, Paulo Giraldo, Iara Linhares, Andrea Haas, E. Rainer Weissenbacher, William J. Ledger, "Value of Candida Polymerase Chain Reaction and Vaginal Cytokine Analysis for the Differential Diagnosis of Women with Recurrent Vulvovaginitis", Infectious Diseases in Obstetrics and Gynecology, vol. 8, Article ID 907480, 4 pages, 2000.

Value of Candida Polymerase Chain Reaction and Vaginal Cytokine Analysis for the Differential Diagnosis of Women with Recurrent Vulvovaginitis

Received18 Aug 2000
Accepted01 Nov 2000


Objectives: Recurrent vulvovaginitis remains difficult to diagnose accurately and to treat. The present investigation evaluated the utility of testing vaginal specimens from women with symptomatic recurrent vulvovaginitis for Candida species by polymerase chain reaction (PCR) and for cytokine responses.Methods: Sixty-one consecutive symptomatic women with pruritus, erythema, and/or a thick white discharge and a history of recurrent vulvovaginitis and 31 asymptomatic women with no such history were studied. Vaginal swabs were tested for Candida species by PCR, for the antiinflammatory cytokine interleukin (IL)-10, and for the proinflammatory cytokine IL-12.Results: C. albicans was detected in 19 (31.1%) of the patients as well as in three (9.7%) controls (P = 0.03). Both IL-10 (31.1% vs. 0%).and IL-12 (42.6% vs. 6.5%) were also more prevalent in the recurrent vulvovaginitis patients (P < 0.001). However, there was no relation between the presence or absence of Candida and either cytokine. Detection of IL-12 in 14 women indicated the stimulation of a vaginal cell-mediated immune response possibly from an infectious agent. The presence of only IL-10 in six patients indicated a suppression of vaginal cell-mediated immunity and was consistent with a possible allergic etiology. The absence of both IL-10 and IL-12 in other patients, similar to that found in healthy controls, suggested a noninfectious, nonallergic etiology of their symptoms.Conclusion: Many women with recurrent vulvovaginitis are not infected with Candida. Testing for Candida should be required in this population. Treatment with only anti-Candida medication will clearly be inadequate for the majority of women with this condition. Infect. Dis. Obstet. Gynecol. 8:244–247, 2000.

Copyright © 2000 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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