I agree with Dr. Jack that the treatment sometimes has to fit the symptoms,
even we don't have proof of illness.  Even with yeast vulvovaginitis we may
not be able to see the yeast organism on smears, but the woman has itching
(scratch, scratch), and her bottom looks like some turned on a red light bulb
under it.  She sure is grateful when the antifungal medication starts to
work.  Remember, medicine is an art, not a science, and sometimes we just
have to put the picture together rather than relying on hard and fast
evidence.....V. Nichols-Johnson, MD