10 A fishy odor makes candidiasis less likely. bacterial vaginosis are a cheesy, curdy, or flocculent discharge itching vulvar or vaginal inflammation or redness and lack of odor. Signs and symptoms that increase the likelihood of vulvovaginal candidiasis vs. 2011 83(7):809, with additional information from references 9 and 16. Sperm, douching, latex condoms or diaphragms, tampons, topical products, medications, clothing, atopic historyĪdapted with permission from Hainer BL, Gibson MV.
Soaps, tampons, contraceptive devices such as condoms or diaphragms, sex toys, pessaries, topical products, douching, fastidious cleansing, medications, clothing Menopause, lactation, oophorectomy, radiation therapy, chemotherapy, immunologic disorders, premature ovarian failure, endocrine disorders, antiestrogen medications Low socioeconomic status, multiple sex partners, other sexually transmitted infections, unprotected intercourse, drug use, smoking Recent antibiotic use, pregnancy, uncontrolled diabetes mellitus, AIDS, corticosteroid use, other immunosuppression Low socioeconomic status, vaginal douching, smoking, new or multiple sex partners, unprotected intercourse, women who have sex with women Risk Factors Contributing to Vaginitis Type of vaginitis Purulent vaginal discharge, burning, dyspareunia Inflammation thin, friable vaginal mucosa Thin, clear discharge vaginal dryness dyspareunia itching Increased risk of HIV infection Increased risk of preterm labor Should be screened for other sexually transmitted infections Green or yellow, frothy discharge foul odor vaginal pain or soreness
White, thick, cheesy, or curdy discharge vulvar itching or burning no odor Increased risk of HIV, gonorrhea, chlamydia, and herpes infectionsĬandida albicans, can have other Candida species Signs and Symptoms of Vaginitis DiagnosisĪnaerobic bacteria (Prevotella, Mobiluncus, Gardnerella vaginalis, Ureaplasma, Mycoplasma)įishy odor thin, homogenous discharge that may worsen after intercourse pelvic discomfort may be present
Studies have shown a negative effect on quality of life in women with vaginitis, with some women expressing anxiety, shame, and concerns about hygiene, particularly in those with recurrent symptoms. 1 Most women have at least one episode of vaginitis during their lives, 2 making it the most common gynecologic diagnosis in primary care. Vaginitis is characterized by vaginal symptoms, including discharge, odor, itching, irritation, or burning. Inflammatory vaginitis may improve with topical clindamycin as well as steroid application. Atrophic vaginitis is treated with hormonal and nonhormonal therapies. Treatment of noninfectious vaginitis should be directed at the underlying cause. Trichomoniasis is treated with oral metronidazole or tinidazole, and patients' sex partners should be treated as well. The Centers for Disease Control and Prevention recommends nucleic acid amplification testing for the diagnosis of trichomoniasis in symptomatic or high-risk women. Treatment of vulvovaginal candidiasis involves oral fluconazole or topical azoles, although only topical azoles are recommended during pregnancy. Culture can be helpful for the diagnosis of complicated vulvovaginal candidiasis by identifying nonalbicans strains of Candida. The diagnosis of vulvovaginal candidiasis is made using a combination of clinical signs and symptoms with potassium hydroxide microscopy DNA probe testing is also available. Bacterial vaginosis is treated with oral metronidazole, intravaginal metronidazole, or intravaginal clindamycin. Newer laboratory tests that detect Gardnerella vaginalis DNA or vaginal fluid sialidase activity have similar sensitivity and specificity to Gram stain. Bacterial vaginosis is traditionally diagnosed with Amsel criteria, although Gram stain is the diagnostic standard. Diagnosis is made using a combination of symptoms, physical examination findings, and office-based or laboratory testing. Noninfectious causes, including atrophic, irritant, allergic, and inflammatory vaginitis, are less common and account for 5% to 10% of vaginitis cases. Bacterial vaginosis is implicated in 40% to 50% of cases when a cause is identified, with vulvovaginal candidiasis accounting for 20% to 25% and trichomoniasis for 15% to 20% of cases. The most common causes of vaginitis are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. Vaginitis is defined as any condition with symptoms of abnormal vaginal discharge, odor, irritation, itching, or burning.
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