Vulvovaginitis: Difference between revisions

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==Background==
==Background==
*Candidiasis and contact vaginitis may occur in virgins
*Definition: inflammation of the vulva and vagina
*[[Candida Vaginitis]] and [[Contact Vulvovaginitis]] may occur in virgins
*Atrophic vaginitis may occur in postmenopausal women
*Atrophic vaginitis may occur in postmenopausal women


==Bacterial Vaginosis==
==Types==
===Background===
{{Vulvovaginitis DDX}}
*Accounts for up to 50% of cases
*Associated w/ preterm labor
*Treat all symptomatic women (including pregnant)
*Do not treat asymptomatic women (including pregnant)


===Diagnosis===
==See Also==
*Whitish-discharge and odor
*[[Pelvic Pain]]
**Lack of discharge makes diagnosis less likely
*Wet mount shows clue cells


===Treatment===
==References==
*Do NOT need to treat sexual partner
<references/>
*Metronidazole 500mg PO BID x7d
[[Category:OBGYN]]
**Single dose tx not as efficacious; not recommended by CDC
[[Category:ID]]
 
==Candida Vaginitis==
===Background===
*Not considered an STI although it can be transmitted by sexual intercourse
*May occur in premarnarcheal girls (rare)
*Types
**Uncomplicated
***Sporadic infxn, mild-moderate sx, due to Candida albicans, immunocompetent
**Complicated
***Recurrent infxn, severe sx, uncontrolled DM, immunosuppression, pregnant
 
===Diagnosis===
*Vaginal pruritus is the most common and specific symptom
*Dischrage varies from little to copious and from watery to cottage-cheese like
*Odor is unusual (if present favors dx of BV)
*Wet mount shows hyphae and yeast buds
**Candida does not cause WBCs on wet mount, think about co-infection with other vaginitides or STI
 
===Treatment===
*Do not treat if asymptomatic
*Sexual partners should not be treated unless the pt has frequent recurrences
*Single-dose tx w/ oral flucon is as effective as topical tx but can't use in pregnancy
*Uncomplicated
**Clotrimazole 100mg vaginal tablet; 2 tablets/d x3d OR
**Fluconazole 150mg PO x1dose
*Complicated
**Fluconazole 150mg PO on days 1 and 3 (not recommended for pregnant pts)
**Topical azole therapy x7d (for pregnant pts)
 
==Trichomonas==
===Background===
*Considered an STI
*A/w preterm birth, PID, cervical cancer, increased transmission of other STIs
 
===Diagnosis===
*Yellow, malordorous discharge
*Vaginal erythema or edema
*Wet mount shows mobile trichomonads
 
===Treatment===
*Treat sexual partners
*Metronidazole 2gm PO in single dose
*If pregnant d/w OB prior to TX, Flagyl associated with preterm labor
**Metronidazole 500mg PO BID X 7d
 
==Contact Vulvovaginitis==
*Due to exposure of vulvar epithelium and vaginal mucosa to chemical irritant or allergen
*Diagnosis of exclusion; rule-out infectious cause first
*Consider tx w/ topical corticosteroids applied BID-TID x2-3d
 
==Source==
Tintinalli
 
[[Category:OB/GYN]]

Revision as of 01:12, 24 July 2017

Background

Types

Vulvovaginitis

See Also

References