Vulvovaginitis

Info

🌱 來自: Huppert’s Notes

Vulvovaginitis🚧 施工中

Vulvovaginitis

•   Physical exam: Pelvic exam

•   Differential diagnosis:

-   Bacterial vaginitis (BV)

•   Etiology: Vaginal inflammation caused by the overgrowth of anaerobic bacteria naturally found in the vagina

•   Symptoms: Malodorous vaginal discharge, may be asymptomatic

•   Physical exam: Fishy odor, grey discharge, no vaginal or vulvar inflammation

•   Diagnosis: Positive whiff test, clue cells on microscopy, pH >4.5

•   Treatment: PO metronidazole

-   Vulvovaginal candidiasis

•   Etiology: Vaginal and vulval symptoms caused by yeast, most often Candida albicans

•   Symptoms: Thick “cottage cheese” discharge, pruritus. Can occur in an atrophic/dry form

•   Physical exam: Vulvar inflammation, thick white discharge, may have vaginal dryness

•   Diagnosis: Pseudohyphae/hyphae on microscopy, pH 4–4.5

•   Treatment: PO fluconazole or vaginal clotrimazole

-   Trichomonas

•   Etiology: Sexually transmitted infection caused by the parasite Trichomonas vaginalis

•   Symptoms: Frothy yellow/green discharge

•   Physical exam: Petechiae (strawberry patches) in the vagina

•   Diagnosis: Organisms present on microscopy, pH 5–6

•   Treatment: PO metronidazole (for patient AND partner)

•   Additional management: In addition to condition-specific treatment as above, provide counseling on safe sex practices, offer additional STI testing, discuss contraception options, and screen for intimate partner violence