A client reports vulvar pruritus. Which assessment finding most strongly suggests a Candida albicans infection?

• A. Cottage cheese-like discharge
• B. Yellow-green discharge
• C. Gray-white discharge
• D. Discharge with a fishy odor

Answer: (A)

Candida vulvovaginal candidiasis often presents with itching and a thick, white, cottage cheese–like discharge. That curdled, odorless discharge is the classic hallmark of a yeast infection, reflecting overgrowth of Candida on the vaginal mucosa. In contrast, other infections produce different discharge patterns: Trichomonas typically causes a yellow-green, sometimes frothy discharge with irritation, and bacterial vaginosis usually yields a thin, gray-white discharge with a fishy odor and a higher vaginal pH. So the cottage cheese–like discharge most strongly points to Candida albicans as the cause. Microscopic testing (e.g., KOH prep showing pseudohyphae and budding yeast) can confirm the diagnosis if needed.