Gram stain versus culture in the diagnosis of vulvovaginal candidiasis.

We evaluated Gram stain as a rapid diagnostic method for vulvovaginal candidiasis (VVC). Vaginal swabs were taken from 100 pregnant women and subjected to Gram stain and culture; 39% were diagnosed as having VVC (29% had symptomatic VVC and 10% had asymptomatic VVC). Candida albicans was isolated from 94.9% of all cultures while other Candida species were isolated from 5.1% of cases. Multigravidae were significantly more affected than primigravidae. Gram stain is a valuable method in rapid accurate diagnosis of symptomatic VVC and even superior to culture as it demonstrates the invasive forms of the yeast. However, its low sensitivity could restrict its use in routine practice. A combination of culture and Gram stain is the ideal approach for the diagnosis of VVC.