Diagnosis

1. The vaginal pH is typically 4 to 4.5, which distinguishes candidiasis from Trichomonas or bacterial vaginosis. The diagnosis is confirmed by finding the organism on a wet mount; adding 10% potassium hydroxide facilitates recognition of budding yeast and hyphae. Microscopy is negative in 50% of patients with vulvovaginal candidiasis.

2. Empiric therapy is often considered in women with typical clinical features, a normal vaginal pH, and no other pathogens visible on microscopy. Culture should be performed in patients with persistent or recurrent symptoms.

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