Vaginal Discharge/vaginitis

Vaginal Discharge/vaginitis is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Vaginitis is vulvovaginal inflammation with or without abnormal vaginal discharge.
    • Common symptoms: Itching, burning, irritation, pain.
    • Abnormal discharge is defined as an increased amount or change in color.
  • Some amount of vaginal discharge is normal.
    • Glands in the cervix produce clear mucus that may turn white or yellow when exposed to air.

Etiology

  • Bacterial vaginosis (BV):
    • The most common cause
    • Loss of normal Lactobacillus sp. (e.g., antibiotics)
    • Inability to maintain normal vaginal pH
    • Overgrowth of normally present bacteria such as Gardnerella vaginalis, Mycoplasma hominis, Mobiluncus sp., Prevotella sp., and Peptostreptococcal
  • Bacterial infections:
    • Trichomonas vaginalis (Trichomoniasis)
    • Group A strep
    • Staphylococcus aureus
  • Fungal infections:
    • Candida sp. most common
    • Often underlying immune dysfunction:
      • Diabetes
      • HIV
  • Chemical irritants
  • Foreign body
  • Atrophic vaginitis:
    • Caused by estrogen deficiency
  • Hypersensitivity
  • Collagen vascular disease
  • Herpes simplex virus (HSV):
    • Vulvovaginitis
    • Cervicitis
  • Lichen sclerosis (atrophic)
  • Fistula

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