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Medical Editor:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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For healthy people, most physicians can diagnose a candidal infection without laboratory tests. Occasionally, if the infection won't go away or involves the entire body, more extensive tests may need to be performed.

• The only definitive way to diagnose a vaginal yeast infection is to complete a full gynecologic exam.
  • This exam includes a speculum exam, using a specialized instrument to hold open your vagina. The exam can be uncomfortable because of pressure against the tissues. The health care practitioner will take a swab of the discharge and may obtain other cultures to rule out other diseases. The swab for yeast will be mixed with a drop of potassium hydroxide and will be placed on a slide. If yeast are present, a specific branching pattern will be seen through the microscope.
  • The doctor then may insert two fingers into your vagina and gently press on your uterus, ovaries, and surrounding areas to check for any tenderness or other problems. The health care practitioner also may take blood and urine specimens after this exam. You should not douche or have sexual intercourse 1-2 days before the exam, because doing so may make the diagnosis more difficult.
• In healthy children and adults, a quick exam in the mouth or of the skin usually confirms the diagnosis of candidiasis. If there is any confusion about the diagnosis, the health care practitioner may obtain a small scraping of the area, which will be placed on a slide with potassium hydroxide and examined for a branching pattern consistent with yeast.
• In people with weakened immune systems, oral, vaginal, and skin candidal infections usually can be diagnosed by sight. When a person becomes sick, the health care practitioner may perform more invasive tests to confirm the diagnosis. Specimen collection may be necessary to check for Candida in the blood and urinary tracts. People with catheters may have their catheters changed and the catheter tips sent for culture. If a CT scan or MRI indicates candidiasis of the brain, health care practitioners may take a biopsy to distinguish between Candida and other diseases. Usually health care practitioner give IV medications for serious systemic infections.

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