Case 1:

A 22 years old pregnant woman had just completed a two-week course of ampicillin for the treatment of E coli pyelonephritis. She then started experiencing perivaginal pruritus, dysuria, and burning in the vulvar region, and noted thick curd like vaginal discharge. On examination the vulvar and labial region was mildly erythematous; tiny papulopustular lesions were seen on the perineum. Shallow linear ulcerations were noted on the posterior part of the introitus. A thick whitish discharge was noted, there was no foul odor.

1. What are the agents that can cause vaginitis?
2. What are the distinguishing characteristics of each. 
3. What diagnostic procedures are helpful in establishing the etiology of vaginitis?  
4. What is the likely diagnosis?  
5. What is the source for this organism?
6. What are the virulant factors of this organism?
7. What are the human defences against this organism?
8. What factors facilitate causation of disease by this organism? Which of these was most important in our patient? 
9. What are the treatment options for this patient? 
10. What other syndromes are caused by this pathogen? 
11. What other Candida species are associated with human diseases?