Discharged 2

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.

Select Relevant Investigations
10% KOH smear

Performed

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

Performed

Cultures are positive for Candida albicans.
Culture for T. vaginalis

Performed

Cultures are negative for Trichomonas.
GC/CT NAAT

Performed

Negative for Chlamydia
Negative for Gonorrhea

Select Relevant Management
Avoid sexual intercourse
Treat partner
Intravaginal Clotrimazole
Oral Metronidazole