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Female Vag. Infect.

Female Vaginal Infections Differential Diagnosis

QuestionAnswer
Vaginal infections often produce a discharge Vaginal infections
Increase in discharge; clear or mucoid discharge; pH<4.5; Physiologic vaginitis
Diagnostic Tests - wet mount; up to 3 to 5 WBCs; epithelial cells Physiologic vaginitis
No foul odor, itching or edema; foul-smelling discharge; complains of "fishy odor"; homogenous thin, white or gray discharge; pH<4.5 Bacterial vaginosis (Gardnerella vaginalis)
Diagnostic Tests - + KOH "whiff" test; wet mount: + clue cells Bacterial vaginosis
Pruritic discharge; itching of labia; itching may extend to thighs; white, curdy discharge; pH 4.0 to 5.0; cervix may be red; may have erythema of perineum and thighs Candida vulvovaginitis (Candida albicans)
Diagnostic Tests - KOH prep; mycelia budding, branching yeast, pseudohyphae Candida vulvovaginitis
Watery discharge; foul odor; dysuria and dyspareunia with severe infection; profuse, frothy, greenish discharge; pH 5.0 to 6.6; red friable cervix with petechia (strawberry cervix) Trichomoniasis (Trichomonas vaginalis)
Diagnostic Tests - West mount; round or pear shaped protozoa; motile "gyrating" flagella Trichomoniasis
Partner with STI; often asymptomatic or may have symptoms of PID; purulent discharge from cervix; Skene/Bartholin gland inflammation; cervix and vulva may be inflammed Gonorrhea (Neisseria gonorrhoeae)
Diagnostic Tests - Gram stain; culture; DNA probe Gonorrhea
Partner with nongonococcal urethritis; often asymptomatic; may complain of spotting after intercourse or urethritis; +/- purulent discharge; cervix may or may not be red or friable Chlamydia (Chlamydia tachomatis)
Diagnostic Tests - DNA probe Chlamydia
Dyspareunia; vaginal dryness; perimenopausal or postmenopausal; pale, thin vaginal mucosa; pH<4.5 Atrophic vaginitis
Diagnostic Tests - Wet mount; folded, clumped epithelial cells Atrophic vaginitis
New bubble bath, soap, douche, or other hygiene products; foul smell; erythema; pH<4.5 Allergic vaginitis
Diagnostic tests - Wet mount: WBC's Allergic vaginitis
Red and swollen vulva; vaginal discharge; history of use of tampon, condom, or diaphragm; bloody or foul-smelling discharge Foreign Body
Diagnostic Tests - wet mount: WBCs Foreign Body
Created by: schnackerfarm
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