USMLE Reviewer
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A 56-year-old diabetic woman has recently been treated with a 2-week course of antibiotics for a skin infection. She returns to the clinic for follow-up with a new complaint of a “cottage cheese-like” vaginal discharge with significant vaginal itching. The most likely cause of these symptoms is
A. C. granulomatis.
B. C. albicans.
C. chancroid.
D. herpes simplex.
E. Neisseria meningitidis.
2. The answer is B. C. albicans is a major cause of vulvovaginitis. Many women are carriers of the yeast, and it, therefore, constitutes normal vaginal flora, although there are many conditions that alter the vaginal microenvironment, including pregnancy, oral contraceptives, and systemic antibiotics, making overgrowth possible. C. granulomatis causes granuloma inguinale. Chancroid results in painful genital ulcers and is caused by the organism H. ducreyi. HSV type 2 can cause genital vesicular lesions. N. meningitidis can cause meningitis.
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