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Causes of Genitourinary Symptoms in Women

Ilene Singer Levenson, MD; Morris Notelovitz, MD, PhD
JAMA. 1984;252(13):1684. doi:10.1001/jama.1984.03350130015017.
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To the Editor.—  The article by Berg et al prospectively evaluating the diagnosis of genitourinary symptoms in women in a family practice setting by means of history, physical examination, and selected laboratory tests failed to include a search for Torulopsis glabrata in women with vaginal discharge who do not have evidence of hyphae on potassium hydroxide vaginal smear.Although T glabrata is usually considered to be a minor pathogen that causes symptoms of vaginitis only in association with other infectious organisms, at the Center for Climacteric Studies we have noticed a dramatically increasing incidence of vaginitis with T glabrata as the primary pathogen. Diagnosis is made in women with classic signs and symptoms of Candida albicans vaginitis who have no evidence of hyphae and have characteristic "fat cells" seen microscopically on potassium hydroxide-prepared vaginal smears. This finding can be easily overlooked as an artifact if not recognized.In contrast to

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