Ureaplasmosis Masked as Candidiasis: A Case of Successful Treatment in a Young Patient


A young woman presented to the hospital complaining of recurrent “candidiasis“: she had been treated at least 6 times in the past year!


The patient was troubled by yellowish, unpleasant-smelling discharge from her genitals. However, at the time of presentation, she did not experience vaginal itching or burning.

She expressed frustration with the constant use of suppositories and tablets, as any prescribed treatment only provided temporary relief, with symptoms worsening after therapy.

According to the patient, symptoms worsened with dietary disturbances, after systemic antibacterial therapy, and before menstruation.

Medical History

The onset of the problem was linked to a coronavirus infection, which she had experienced in a moderate form. The patient underwent intensive treatment in the hospital and took numerous medications, including antibiotics.

After some time post-recovery and discharge, the first symptoms of “candidiasis” appeared: intense itching, burning, and irritation in the vagina, as well as abundant curd-like discharge. Treatment prescribed by the gynecologist temporarily relieved the woman, but symptoms returned after 3 months. This time, she experienced abundant discharge and vaginal irritation.

The patient consulted the doctor again, and the same (successful) treatment regimen was recommended. A swab for flora revealed “abundant cocobacillary flora and clue cells” – markers of vaginal microflora imbalance with predominance of cocobacilli. The woman also tested positive for ureaplasmosis and gardnerellosis. She did not undergo repeat follow-up testing.

For the past six months, at the slightest discomfort in the vagina, the patient would use antibacterial suppositories to prevent “candidiasis” recurrence. This condition affected her daily and sexual life, causing constant tension and discomfort.

The patient uses daily pads regularly.

She suffers from chronic gastritis and duodenitis. The last exacerbation occurred about a year ago (after treatment for coronavirus infection). There were no traumas, surgeries, or blood transfusions. She has no medication allergies.

No similar problems were reported among her relatives.


At the time of examination, it was the 19th day of the patient’s menstrual cycle.

The vaginal mucosa was pink, the cervix was clean, with no redness or inflammation. Discharge from the genitals was abundant, yellowish, and mucous, with a specific odor.

A special test strip (colpo-test) showed an increase in vaginal fluid acidity to pH 4.8. This indicates disruptions in vaginal microbiota or the development of infections.

Detailed analysis of the vaginal microbiota composition (Femoflor Screen) revealed:
• slight increase in the amount of conditionally pathogenic flora: Candida – 103.5 CFU/ml, Ureaplasma – 104.9 CFU/ml;
• decrease in lactobacilli levels – 106.4 CFU/ml;
• no sexually transmitted infections were detected.


Disruption of vaginal microflora. N89 Noninflammatory disorder of vagina.


Considering the absence of inflammation, itching, and irritation, and based on the examination results, the woman was prescribed systemic therapy:
• discontinuation of daily pads use, as their adhesive layer prevents the skin from “breathing,” and accumulated secretions, coming into contact with the vaginal mucosa and labia, cause irritation;
• daily intimate hygiene with plain water or products containing lactobacilli, as well as hygiene before and after sexual intercourse;
• dietary correction: since the woman is prone to digestive problems, she was advised to avoid sweets, carbonated drinks, and alcohol and prioritize a gentle diet;
• treatment aimed at correcting vaginal microflora.
The woman’s sexual partner was also advised to undergo screening for sexually transmitted infections.

A month after starting treatment, symptoms resolved. A follow-up Femoflor Screen showed a decrease in Ureaplasma levels.

For the next two years, “candidiasis” symptoms did not recur. The patient became pregnant.


Ureaplasma spp., Urealitycum, and Parvum are representatives of conditionally pathogenic vaginal microflora, which always inhabit our bodies. Both men and women have them.

So what happened to the patient? Like many others, she suffered from systemic antibacterial therapy, which disrupted the delicate balance of vaginal flora, mistaking ureaplasma for an infection, the woman “eliminated” all her native vaginal inhabitants.

Therefore, in response to the popular question of whether ureaplasma should be treated, it is tempting to say that they, ureaplasmas, are perfectly healthy. However, if there are complaints related to pathological discharge or urinary disorders, one cannot rely solely on local antibacterial treatment. In this case, it is necessary to consult a doctor who can prescribe effective individual therapy.