Signs of a Yeast Infection
Or is it Cytolytic Vaginitis?
The signs of a yeast infection can be confusing even for the experts.
Cytolytic vaginitis (often called Cytolytic vaginosis) is being misdiagnosed as yeast infection in more woman than it should, according to this study of 210 women.1
These women all had a whitish discharge, something that is typically a sign of yeast infection.
Other symptoms from the group of 210 were:
- 33 had a smelly discharge
- 32 had itchiness (pruritus)
- 21 had redness and swelling of vulva or vagina (erythema and edema)
- 9 had experienced painful intercourse (dyspareunia)
These were women that normally would have been treated - or treated themselves - for vaginal thrush (yeast infection).
27 of the 210 women were diagnosed with yeast infection.
But out of those 27 women, 15 of the women ACTUALLY had Cytolytic vaginitis, diagnosed by the absence of yeast in the vaginal swab culture and by the abundant lactobacilli and fragmented epithelial cells and/or free nuclei. Vaginal pH was 4.0-4.5 in all of these women.
A simple at-home test for vaginal pH would have assisted a correct diagnosis.
All of the 15 women that were diagnosed with CV were in the reproductive age group of 25 to 40 years. 5 of them were in the last half of their menstrual cyle and this increased both the vaginal discharge and the itchiness. Women with cytolytic vaginosis find that in this phase of the menstrual cycle there seems to be a remarkable rise in the number of colonizing Lactobacilli. Remember, they are a helpful bacteria and normally are members of the good guy group in the vagina but with CV there are just too many Lactobacilli.
CV used to be called Lactobacillus overgrowth syndrome or Doderlein’s cytolysis. The word "cytolysis" means fragmentation and with CV, this is exactly what happens to the cells that line the vaginal walls.
As one of the key signs of a yeast infection is the white discharge and CV also has a white discharge, if a woman is able to test her own vaginal pH this helps to guide her towards the right treatment.
REFERENCES
1. Nilgun Cerikcioglu1 and M. Sinan Beksac. Cytolytic vaginosis: misdiagnosed as candidal vaginitis. Infect Dis Obstet Gynecol 2004;12:13 ? 16
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