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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 |
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| ==Bacterial Vaginosis== | | ==Types== |
| ===Background===
| | {{Vulvovaginitis DDX}} |
| *Accounts for up to 50% of cases
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| *Associated w/ preterm labor
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| *Treat all symptomatic women (including pregnant)
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| *Do not treat asymptomatic women (including pregnant)
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| ===Diagnosis=== | | ==See Also== |
| *Whitish-discharge and odor
| | *[[Pelvic Pain]] |
| **Lack of discharge makes diagnosis less likely
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| *Wet mount shows clue cells | |
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| ===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]] |
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| ==Candida Vaginitis==
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| ===Background===
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| *Not considered an STI although it can be transmitted by sexual intercourse
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| *May occur in premarnarcheal girls (rare)
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| *Types
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| **Uncomplicated
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| ***Sporadic infxn, mild-moderate sx, due to Candida albicans, immunocompetent
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| **Complicated
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| ***Recurrent infxn, severe sx, uncontrolled DM, immunosuppression, pregnant
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| ===Diagnosis===
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| *Vaginal pruritus is the most common and specific symptom
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| *Dischrage varies from little to copious and from watery to cottage-cheese like
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| *Odor is unusual (if present favors dx of BV)
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| *Wet mount shows hyphae and yeast buds
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| **Candida does not cause WBCs on wet mount, think about co-infection with other vaginitides or STI
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| ===Treatment===
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| *Do not treat if asymptomatic
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| *Sexual partners should not be treated unless the pt has frequent recurrences
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| *Single-dose tx w/ oral flucon is as effective as topical tx but can't use in pregnancy
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| *Uncomplicated
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| **Clotrimazole 100mg vaginal tablet; 2 tablets/d x3d OR
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| **Fluconazole 150mg PO x1dose
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| *Complicated
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| **Fluconazole 150mg PO on days 1 and 3 (not recommended for pregnant pts)
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| **Topical azole therapy x7d (for pregnant pts)
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| ==Trichomonas==
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| ===Background===
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| *Considered an STI
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| *A/w preterm birth, PID, cervical cancer, increased transmission of other STIs
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| ===Diagnosis===
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| *Yellow, malordorous discharge
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| *Vaginal erythema or edema
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| *Wet mount shows mobile trichomonads
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| ===Treatment===
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| *Treat sexual partners
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| *Metronidazole 2gm PO in single dose
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| *If pregnant d/w OB prior to TX, Flagyl associated with preterm labor
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| **Metronidazole 500mg PO BID X 7d
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| ==Contact Vulvovaginitis==
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| *Due to exposure of vulvar epithelium and vaginal mucosa to chemical irritant or allergen
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| *Diagnosis of exclusion; rule-out infectious cause first
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| *Consider tx w/ topical corticosteroids applied BID-TID x2-3d
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| ==Source==
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| Tintinalli
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| [[Category:OB/GYN]] | |