Vaginitis. This post will cover the points you need to know for your board exams as well as for teaching residents on the daily rounds. Please don't use the information here to treat your patients.
There are 3 relevant types of vaginitis encountered in medical practice:
1- Bacterial vaginosis caused by anaerobic bacteria characterized by fishy smelling grayish white discharge with positive whiff amine test where fishy odor accentuates on adding 10% KOH. Clue cells are seen on microscopy. Diagnosis is by a DNA probe. Treatment with metronidazole 500 mg BID for 7 days.
2- Trichomoniasis caused by Trichomonas vaginalis characterized by frothy yellow-green foul-smelling discharge with erythema (strawberry cervix). Microscopy can visualize the organisms. Diagnosis by PCR. Treatment with metronidazole 2 g one dose or 500 mg BID for 7 days. The only vaginitis that is sexually transmitted, treat the male partner as well.
3- Vulvovaginal candidiasis caused by Candida albicans and characterized by white cottage cheese discharge where fungal elements can be seen on wet prep. Treat with topical and oral antifungal agents.
An informative entertaining book is the Graphic Guide to Infectious Disease.
The information in this post is not for patients and shouldn't be used in treating patients. Please refer to your doctor for medical advice.