Vaginal discharge: Difference between revisions

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__NOTOC__
'''For patient information, click [[Vaginal discharge (patient information)|here]]'''
'''For patient information, click [[Vaginal discharge (patient information)|here]]'''


{{Infobox_Disease |
  Name          = {{PAGENAME}} |
  Image          = |
  Caption        = |
  DiseasesDB    = |
  ICD10          = |
  ICD9          = |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = 003158 |
  eMedicineSubj  = |
  eMedicineTopic = |
  MeshID        = |
}}
{{SI}}
{{SI}}
{{CMG}};  '''Associate Editor(s)-in-Chief:''' [[User: Shankar Kumar |Shankar Kumar, M.B.B.S.]] [mailto:kumarshankar@wikidoc.org]]
{{CMG}};  {{AE}} [[User: Shankar Kumar|Shankar Kumar, M.B.B.S.]] [mailto:kumarshankar@wikidoc.org]


{{EH}}  
{{SK}} Discharge from the vagina


==Overview==
== Overview ==
'''Vaginal discharge''' is a common patient complaint that is paired with anxiety regarding sexually transmitted diseases. If a STD is detected, a search for all other STDs should be done. Advise the infected patient to inform all sexual partners of their diagnosis.
Vaginal discharge is a common patient complaint that is paired with [[anxiety]] regarding [[sexually transmitted diseases]]. If a STD is detected, a search for all other STDs should be done. Advise the infected patient to inform all sexual partners of their diagnosis.


===Complete Differential Diagnosis of the Causes of Vaginal discharge===
==Causes==
(By organ system)
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| [[Scabies]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Amoxicillin and Clavulanic Acid ]], [[Butoconazole Vaginal Cream ]], [[Clotrimazole ]], [[Combined oral contraceptive pill]], [[Estradiol Topical ]], [[Estradiol Transdermal ]], [[Estrogen and Progestin (Oral Contraceptives) ]],[[Estrogen Injection ]], [[Estrogen Vaginal ]], [[Etonogestrel and Ethinyl Estradiol Vaginal Ring ]], [[Glatiramer Injection ]],[[Hormone replacement therapy (trans)]], [[Leuprolide ]], [[Medroxyprogesterone Injection ]], [[Metronidazole Topical ]],[[Miconazole ]], [[Nafarelin ]], [[Natalizumab injection ]], [[Norelgestromin and ethinyl estradiol transdermal system ]],[[Oxcarbazepine ]], [[Tamoxifen ]], [[Terconazole Vaginal Cream, Vaginal Suppositories ]], [[Zoledronic Acid Injection ]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| [[Colposcopy]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Pelvic inflammatory disease]], [[Urethritis]], [[Cervicitis]], [[Vaginitis]], [[Vulvitis]]


<u>'''Bacteria'''</u>:
===Common Causes===
[[Bacterial Vaginosis]], [[Chlamydia]], [[Gonorrhea]], [[Syphilis]]


<u>'''Viral'''</u>:
* [[Atrophic vaginitis]]
[[Herpes simplex]], [[HIV]], [[Human Papillomavirus infections]]
* [[Bacterial vaginosis]]
* [[Cervical cancer]]
* [[Chlamydia]]
* [[Foreign body vaginitis]]
* [[Gonorrhea]]
* [[Herpes]]
* [[Trichomoniasis]]
* [[Vaginal cancer]]
* [[Vaginal yeast infection]]


<u>'''Fungal'''</u>:
===Causes by Organ System===
[[Candidiasis]]


<u>'''Parasitic'''</u>:
{| style="width:80%; height:100px" border="1"
[[Trichomonas vaginalis]], [[Trichomoniasis]]
| style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|-
| style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Lochia]], [[Menstrual cycle]], [[Postnatal]], [[Pregnancy]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Cervical cancer]], [[Endometrial cancer]], [[Uterine sarcoma]], [[Vaginal cancer]]
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Allergic vaginitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| [[Atrophic Vaginitis]], [[Cervical cancer]], [[Cervical polyp]], [[Cervicitis]], [[Endometrial cancer]], [[Foreign body vaginitis]], [[Salpingitis]], [[Uterine sarcoma]], [[Vaginal cancer]], [[Vaginitis]], [[Vesicovaginal fistula]], [[Vulvitis]],[[Colposcopy]], [[Pelvic inflammatory disease]], [[Allergic vaginitis]], [[Vaginal trauma]], [[Bacterial Vaginosis]],[[Candidiasis]]
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Vaginal trauma]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}
 
 
 
== Laboratory Findings ==
 
Initial tests include:
*[[CBC]]
*[[urinalysis]]
*[[urine]] culture
*[[beta-hCG]]
*[[gonorrhea]] culture
*[[chlamydia]] culture
 
=== Other Diagnostic Studies ===
 
{| style="background:silver; color:black"
|-
| Type
| pH
| Discharge
| Odor
| Wet Mount
|- style="background:silver; color:black"
| Trich
| >4.5
| yellow-green, copious
| present
| motile, flagellated
|- style="background:silver; color:black"
| BV
| >4.5
| white-grey
| fishy
| clue cells
|- style="background:silver; color:black"
| Candida
| <4.5
| white, curd-like
| none
| pseudo-hyphae
|- style="background:silver; color:black"
| GC
|
| mucopurulent
| varies
| PMNs
|- style="background:silver; color:black"
| A.V.
|
| thin,gray,watery
| none
| few epithelial cells
|}
 
===Complete Differential Diagnosis of the Causes of Vaginal discharge===
(By organ system)
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"| [[Scabies]]
| bgcolor="Beige"| [[Scabies]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Amoxicillin and Clavulanic Acid ]], [[Butoconazole Vaginal Cream ]], [[Clotrimazole ]], [[Combined oral contraceptive pill]], [[Estradiol Topical ]], [[Estradiol Transdermal ]], [[Estrogen and Progestin (Oral Contraceptives) ]], [[Estrogen Injection ]], [[Estrogen Vaginal ]], [[Etonogestrel and Ethinyl Estradiol Vaginal Ring ]], [[Glatiramer Injection ]], [[Hormone replacement therapy (trans)]], [[Leuprolide ]], [[Medroxyprogesterone Injection ]], [[Metronidazole Topical ]], [[Miconazole ]], [[Nafarelin ]], [[Natalizumab injection ]], [[Norelgestromin and ethinyl estradiol transdermal system ]], [[Oxcarbazepine ]], [[Tamoxifen ]], [[Terconazole Vaginal Cream, Vaginal Suppositories ]], [[Zoledronic Acid Injection ]]
| bgcolor="Beige"| [[Amoxicillin and Clavulanic Acid ]], [[Butoconazole Vaginal Cream ]], [[Clotrimazole ]], [[Combined oral contraceptive pill]], [[Estradiol Topical ]], [[Estradiol Transdermal ]], [[Estrogen and Progestin (Oral Contraceptives) ]],[[Estrogen Injection ]], [[Estrogen Vaginal ]], [[Etonogestrel and Ethinyl Estradiol Vaginal Ring ]], [[Glatiramer Injection ]],[[Hormone replacement therapy (trans)]], [[Letrozole]], [[Leuprolide ]], [[Medroxyprogesterone Injection ]], [[Metronidazole Topical ]],[[Miconazole ]], [[Nafarelin ]], [[Natalizumab injection ]], [[Norelgestromin and ethinyl estradiol transdermal system ]], [[Ospemifene]], [[Oxcarbazepine ]], [[Pramipexole]], [[Progesterone]], [[Tamoxifen ]], [[Terconazole Vaginal Cream, Vaginal Suppositories ]], [[Toremifene]], [[Zoledronic Acid Injection ]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-  
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-  
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| [[Colposcopy]]
| bgcolor="Beige"| [[Colposcopy]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| [[Pelvic inflammatory disease]], [[Urethritis]], [[Cervicitis]], [[Vaginitis]], [[Vulvitis]]
| bgcolor="Beige"| [[Pelvic inflammatory disease]], [[Urethritis]], [[Cervicitis]], [[Vaginitis]], [[Vulvitis]]


<u>'''Bacteria'''</u>:
<u>'''Bacteria'''</u>:
Line 266: Line 87:
[[Trichomonas vaginalis]], [[Trichomoniasis]]
[[Trichomonas vaginalis]], [[Trichomoniasis]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Lochia]], [[Menstrual cycle]], [[Postnatal]], [[Pregnancy]]
| bgcolor="Beige"| [[Lochia]], [[Menstrual cycle]], [[Postnatal]], [[Pregnancy]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| [[Cervical cancer]], [[Endometrial cancer]], [[Uterine sarcoma]], [[Vaginal cancer]]
| bgcolor="Beige"| [[Cervical cancer]], [[Endometrial cancer]], [[Uterine sarcoma]], [[Vaginal cancer]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Opthalmologic'''
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
| '''Overdose / Toxicity'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Allergic vaginitis]]
| bgcolor="Beige"| [[Allergic vaginitis]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| '''Sexual'''
|bgcolor="Beige"| [[Atrophic Vaginitis]], [[Cervical cancer]], [[Cervical polyp]], [[Cervicitis]], [[Endometrial cancer]], [[Foreign body vaginitis]], [[Salpingitis]], [[Uterine sarcoma]], [[Vaginal cancer]], [[Vaginitis]], [[Vesicovaginal fistula]], [[Vulvitis]], [[Colposcopy]], [[Pelvic inflammatory disease]], [[Allergic vaginitis]], [[Vaginal trauma]], [[Bacterial Vaginosis]], [[Candidiasis]]
| bgcolor="Beige"| [[Atrophic Vaginitis]], [[Cervical cancer]], [[Cervical polyp]], [[Cervicitis]], [[Endometrial cancer]], [[Foreign body vaginitis]], [[Salpingitis]], [[Uterine sarcoma]], [[Vaginal cancer]], [[Vaginitis]], [[Vesicovaginal fistula]], [[Vulvitis]],[[Colposcopy]], [[Pelvic inflammatory disease]], [[Allergic vaginitis]], [[Vaginal trauma]], [[Bacterial Vaginosis]],[[Candidiasis]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| [[Vaginal trauma]]  
| bgcolor="Beige"| [[Vaginal trauma]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dental'''
| '''Dental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige"| No underlying causes
|-
|-
|}
|}


===Complete Differential Diagnosis of the Causes of Vaginal discharge===
===Causes in Alphabetical Order ===
(In alphabetical order)
 
{{MultiCol}}
{{MultiCol}}
*[[Allergic vaginitis]]


*[[Amoxicillin and Clavulanic Acid ]]
* [[Allergic vaginitis]]


*[[Atrophic Vaginitis]]
* [[Amoxicillin and Clavulanic Acid ]]


*[[Bacterial Vaginosis]]
* [[Atrophic Vaginitis]]


*[[Butoconazole Vaginal Cream ]]
* [[Bacterial Vaginosis]]


*[[Candidiasis]]
* [[Butoconazole Vaginal Cream ]]


*[[Cervical cancer]]
* [[Candidiasis]]


*[[Cervical polyp]]
* [[Cervical cancer]]


*[[Cervicitis]]
* [[Cervical polyp]]


*[[Chlamydia]]
* [[Cervicitis]]


*[[Clotrimazole ]]
* [[Chlamydia]]


*[[Colposcopy]]
* [[Clotrimazole ]]


*[[Combined oral contraceptive pill]]
* [[Colposcopy]]


*[[Endometrial cancer]]
* [[Combined oral contraceptive pill]]


*[[Estradiol Topical ]]
* [[Endometrial cancer]]


*[[Estradiol Transdermal ]]
* [[Estradiol Topical ]]


*[[Estrogen and Progestin (Oral Contraceptives) ]]
* [[Estradiol Transdermal ]]


*[[Estrogen Injection ]]
* [[Estrogen and Progestin (Oral Contraceptives) ]]


*[[Estrogen Vaginal ]]
* [[Estrogen Injection ]]


*[[Etonogestrel and Ethinyl Estradiol Vaginal Ring ]]
* [[Estrogen Vaginal ]]


*[[Foreign body vaginitis]]
* [[Etonogestrel and Ethinyl Estradiol Vaginal Ring ]]


*[[Glatiramer Injection ]]
* [[Foreign body vaginitis]]


*[[Gonorrhea]]
* [[Glatiramer Injection ]]


*[[Herpes simplex]]
* [[Gonorrhea]]


*[[HIV]]
* [[Herpes simplex]]


*[[Hormone replacement therapy (trans)]]
* [[HIV]]


*[[Human Papillomavirus infections]]
* [[Hormone replacement therapy (trans)]]
 
* [[Human Papillomavirus infections]]


{{ColBreak}}
{{ColBreak}}


*[[Leuprolide ]]
* [[Leuprolide ]]


*[[Lochia]]
* [[Lochia]]


*[[Medroxyprogesterone Injection ]]
* [[Medroxyprogesterone Injection ]]


*[[Menstrual cycle]]
* [[Menstrual cycle]]


*[[Metronidazole Topical ]]
* [[Metronidazole Topical ]]


*[[Miconazole ]]
* [[Miconazole ]]


*[[Nafarelin ]]
* [[Nafarelin ]]


*[[Natalizumab injection ]]
* [[Natalizumab injection ]]


*[[Norelgestromin and ethinyl estradiol transdermal system ]]
* [[Norelgestromin and ethinyl estradiol transdermal system ]]


*[[Oxcarbazepine ]]
* [[Oxcarbazepine ]]


*[[Pelvic inflammatory disease]]
* [[Pelvic inflammatory disease]]


*[[Postnatal]]
* [[Postnatal]]


*[[Pregnancy]]
* [[Pregnancy]]


*[[Salpingitis]]
* [[Salpingitis]]


*[[Scabies]]
* [[Scabies]]


*[[Syphilis]]
* [[Syphilis]]


*[[Tamoxifen ]]
* [[Tamoxifen ]]


*[[Terconazole Vaginal Cream, Vaginal Suppositories ]]
* [[Terconazole Vaginal Cream, Vaginal Suppositories ]]


*[[Trichomonas vaginalis]]
* [[Trichomonas vaginalis]]


*[[Trichomoniasis]]
* [[Trichomoniasis]]


*[[Urethritis]]
* [[Urethritis]]


*[[Uterine sarcoma]]
* [[Uterine sarcoma]]


*[[Vaginal cancer]]
* [[Vaginal cancer]]


*[[Vaginal trauma]]
* [[Vaginal trauma]]


*[[Vaginitis]]
* [[Vaginitis]]


*[[Vesicovaginal fistula]]
* [[Vesicovaginal fistula]]


*[[Vulvitis]]
* [[Vulvitis]]


*[[Zoledronic Acid Injection ]]
* [[Zoledronic Acid Injection ]]


{{EndMultiCol}}
{{EndMultiCol}}
== Laboratory Findings ==
Initial tests include:
* [[CBC]]
* [[Urinalysis]]
* [[Urine]] culture
* [[Beta-hCG]]
* [[Gonorrhea]] culture
* [[Chlamydia]] culture
=== Other Diagnostic Studies ===
{| style="background:silver; color:black"
|-
| Type
| pH
| Discharge
| Odor
| Wet Mount
|- style="background:silver; color:black"
| Trich
| >4.5
| yellow-green, copious
| present
| motile, flagellated
|- style="background:silver; color:black"
| BV
| >4.5
| white-grey
| fishy
| clue cells
|- style="background:silver; color:black"
| Candida
| <4.5
| white, curd-like
| none
| pseudo-hyphae
|- style="background:silver; color:black"
| GC
|
| mucopurulent
| varies
| PMNs
|- style="background:silver; color:black"
| A.V.
|
| thin,gray,watery
| none
| few epithelial cells
|}


== Treatment ==
== Treatment ==
Line 453: Line 327:
'''See most recent CDC guidelines for all STD's'''
'''See most recent CDC guidelines for all STD's'''


=== Acute Pharmacotherapies ===  
=== Acute Pharmacotherapies ===


====Bacterial Vaginosis====
==== Bacterial Vaginosis ====


*[[Metronidazole]] single dose for 7 days
* [[Metronidazole]] single dose for 7 days


====[[Candida]] and [[Chlamydia]]====
==== [[Candida]] and [[Chlamydia]] ====


*[[Azithromycin]]
* [[Azithromycin]]
*[[doxycycline]]
* [[Doxycycline]]


====Gonorrhea====
==== Gonorrhea ====
*Oral [[ciprofloxacin]] or IM [[ceftriaxone]]


====Trichomonas====
* Oral [[ciprofloxacin]] or IM [[ceftriaxone]]


*[[Metronidazole]] single dose for 7 days
==== Trichomonas ====
*Intravaginal [[clotrimazole]] if pregnant or unable to use [[Metronidazole]]
 
* [[Metronidazole]] single dose for 7 days
* Intravaginal [[clotrimazole]] if pregnant or unable to use [[Metronidazole]]


== References ==
== References ==
{{Reflist|2}}
{{Reflist|2}}


{{Symptoms and signs}}
{{Symptoms and signs}}
{{SIB}}
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{{WikiDoc Sources}}


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[[Category:Gynecology]]
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[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
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Revision as of 16:01, 16 June 2015

For patient information, click here

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shankar Kumar, M.B.B.S. [2]

Synonyms and keywords: Discharge from the vagina

Overview

Vaginal discharge is a common patient complaint that is paired with anxiety regarding sexually transmitted diseases. If a STD is detected, a search for all other STDs should be done. Advise the infected patient to inform all sexual partners of their diagnosis.

Causes

Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical / poisoning No underlying causes
Dermatologic Scabies
Drug Side Effect Amoxicillin and Clavulanic Acid , Butoconazole Vaginal Cream , Clotrimazole , Combined oral contraceptive pill, Estradiol Topical , Estradiol Transdermal , Estrogen and Progestin (Oral Contraceptives) ,Estrogen Injection , Estrogen Vaginal , Etonogestrel and Ethinyl Estradiol Vaginal Ring , Glatiramer Injection ,Hormone replacement therapy (trans), Letrozole, Leuprolide , Medroxyprogesterone Injection , Metronidazole Topical ,Miconazole , Nafarelin , Natalizumab injection , Norelgestromin and ethinyl estradiol transdermal system , Ospemifene, Oxcarbazepine , Pramipexole, Progesterone, Tamoxifen , Terconazole Vaginal Cream, Vaginal Suppositories , Toremifene, Zoledronic Acid Injection
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic Colposcopy
Infectious Disease Pelvic inflammatory disease, Urethritis, Cervicitis, Vaginitis, Vulvitis

Bacteria: Bacterial Vaginosis, Chlamydia, Gonorrhea, Syphilis

Viral: Herpes simplex, HIV, Human Papillomavirus infections

Fungal: Candidiasis

Parasitic: Trichomonas vaginalis, Trichomoniasis

Musculoskeletal / Ortho No underlying causes
Neurologic No underlying causes
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic Lochia, Menstrual cycle, Postnatal, Pregnancy
Oncologic Cervical cancer, Endometrial cancer, Uterine sarcoma, Vaginal cancer
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy Allergic vaginitis
Sexual Atrophic Vaginitis, Cervical cancer, Cervical polyp, Cervicitis, Endometrial cancer, Foreign body vaginitis, Salpingitis, Uterine sarcoma, Vaginal cancer, Vaginitis, Vesicovaginal fistula, Vulvitis,Colposcopy, Pelvic inflammatory disease, Allergic vaginitis, Vaginal trauma, Bacterial Vaginosis,Candidiasis
Trauma Vaginal trauma
Urologic No underlying causes
Dental No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order


Laboratory Findings

Initial tests include:

Other Diagnostic Studies

Type pH Discharge Odor Wet Mount
Trich >4.5 yellow-green, copious present motile, flagellated
BV >4.5 white-grey fishy clue cells
Candida <4.5 white, curd-like none pseudo-hyphae
GC mucopurulent varies PMNs
A.V. thin,gray,watery none few epithelial cells

Treatment

See most recent CDC guidelines for all STD's

Acute Pharmacotherapies

Bacterial Vaginosis

Candida and Chlamydia

Gonorrhea

Trichomonas

References

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