Vaginal discharge

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Vaginal discharge

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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.

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

Differential Diagnosis of Causes of Vaginal discharge

Causes include; [1] [2]

Physiologic

  • Discharge is common, especially mid cycle and premenstrually
  • Common in patients that use oral contraceptives
  • Color, odor or consistancy change require an evaluation
  • Pregnancy results in an incerase in discharge

Cervicitis
Sexually Transmitted Disease

Bacterial Vaginosis

  • Fishy Odor
  • Not an STD
  • Preterm delivery during pregancy risk elevated

Alteration of normal vaginal flora and/or inflammatory response

Foreign body vaginitis
Noninfectious irritant/allergic contact vaginitis
Vaginal trauma Puberty

Other

  • Retain wet mount and KOH of discharge is necessary
  • Discharge PH

Treatment

See most recent CDC guidelines for all STD's

Acute Pharmacotherapies

Bacterial Vaginosis

Candida and Chlamydia

Gonorrhea

Trichomonas

References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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