What symptom is often present in cases of candidal vulvovaginitis?

Candidal vulvovaginitis, commonly caused by an overgrowth of the fungus Candida, is characterized by several distinctive symptoms. One of the hallmark symptoms is itching and irritation of the vulva. This discomfort results from the inflammatory response triggered by the infection. Clinically, patients often describe this sensation as intense itching that can lead to scratching, which may further exacerbate the irritation and discomfort.

The presence of itching and irritation in this condition is due to the yeast's metabolic byproducts, which can irritate the sensitive surrounding tissues. Additionally, patients may experience other symptoms such as a thick, white discharge, commonly referred to as "cottage cheese-like," but the key symptom highlighting candidal vulvovaginitis is indeed the itching.

Other symptoms provided in the options, such as painful lymph nodes, severe dysmenorrhea, or heavy discharge with a foul odor, are generally not associated with candidal infections. Painful swelling of lymph nodes may suggest a systemic infection or a different type of inflammatory response, severe dysmenorrhea is related more to menstrual issues than to yeast infections, and heavy discharge with a foul odor is more characteristic of bacterial vaginosis rather than candidal vulvovaginitis. Thus, recognizing itching