A 35-year-old woman presents to her gynecologist because of vaginal itching and discharge. Pelvic examination demonstrates abundant white, curdy material in the vagina. Microscopic examination of the material demonstrates fungal hyphae and yeast forms. Which of the following systemic diseases can predispose for this condition?

The patient has vulvovaginitis secondary to Candida infection. Predisposing factors include a high vaginal pH, diabetes, and use of antibiotics. The increased vulnerability in diabetes may reflect increased glucose concentrations in vaginal secretions and relative immunosuppression. Crohn's disease can predispose for fistulas involving the vagina, rather than vulvovaginitis. Dissemination of Neisseria gonorrhoeae can cause septic ahritis. Rheumatoid ahritis is not specifically associated with Candida vulvovaginitis. Ref: Brooks G.F. (2013). Chapter 45. Medical Mycology. In G.F. Brooks (Ed), Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e