A 32-year-old woman presented to the outpatient clinic with complaints of vaginal itching and burning that had persisted for the past five days. She described a thick, white, “cottage cheese-like” vaginal discharge and reported significant redness and swelling of the vulva. These symptoms were progressively worsening, causing discomfort during intercourse, although there was no associated foul odor. She denied pain during urination or systemic symptoms such as fever or chills. The patient was sexually active with one partner and reported no recent new sexual contacts. Her last menstrual period occurred two weeks prior. The patient’s medical history was significant for recurrent urinary tract infections, and she had recently completed a 7-day course of antibiotics for cystitis. She denied any chronic medical conditions or regular medications aside from oral contraceptives. She reported no history of similar symptoms in the past. On physical examination, there was notable erythema and edema of the vulva, with some excoriations likely due to scratching. Speculum examination revealed thick, adherent, white plaques coating the vaginal walls. A bimanual examination showed no cervical motion tenderness, uterine tenderness, or adnexal masses. Microscopy of the vaginal discharge using 10% potassium hydroxide (KOH) preparation revealed budding yeast and pseudohyphae. Which of the following is a characteristic feature of this disorder concerning vaginal secretions?
