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*NAAT is highly sensitive for the diagnosis of Trichomonas vaginalis. | *NAAT is highly sensitive for the diagnosis of Trichomonas vaginalis. | ||
*Treatment is initiated after confirmation of the diagnosis | *Treatment is initiated after confirmation of the diagnosis | ||
|Metronidazole 2g or | | | ||
*Metronidazole 2g or Tinidazole 2g in a single dose | |||
|- | |- | ||
| [[Atrophic Vaginitis]] ||Normal|| Vaginal smear cytology shows increased parabasal cells||Leftward shift of the vaginal maturation index | | [[Atrophic Vaginitis]] ||Normal|| Vaginal smear cytology shows increased parabasal cells||Leftward shift of the vaginal maturation index |
Revision as of 21:59, 13 January 2017
Vaginitis
Overview
Vulvovaginitis is a common condition for which women seek medical care accounting for approximately 10 million office visits every year. It is defined as symptoms that cause itching, irritation, burning and abnormal vaginal discharge. The three common causes of vaginal discharge in reproductive age group include: most common being Bacterial Vaginosis followed by Candida vulvovaginitis and Trichomoniasis.
Synopsis
Symptoms
Disease | Symptoms | Examination Findings | |||||
---|---|---|---|---|---|---|---|
Discharge | Dysuria | Vaginal odor | Dyspareunia | Genital skin lesion | Genital pruritus | ||
Candida Vulvovaginitis | ✔ | ✔ | ✔ | ✔ | ✔ | ✔✔ |
|
Bacterial Vaginosis | ✔ | ✔ |
| ||||
Trichomoniasis | ✔ | ✔ | ✔ | ✔ | ✔ |
| |
Atrophic Vaginitis | ✔ | ✔ | ✔ | ✔✔ | ✔ | ✔ |
|
Diagnosis and Treatment
Disease | Investigation | Diagnostic Approach | Treatment | ||
---|---|---|---|---|---|
pH | Saline Wet mount preparation | Gold Standard test | |||
Candida Vulvovaginitis | Normal | Hyphae and pseudohyphae can be demonstrated | Culture |
|
|
Bacterial Vaginosis | >4.5 | Clue cells are demonstrated | Gram Stain to determine the relative concentration of lactobacilli, G. vaginalis, Prevotella, Porphyromonas, peptostreptococci and Mobiluncus |
Amsel’s criteria: Presence of three out of four criteria is required to make the diagnosis of BV
|
|
Trichomoniasis | Normal |
|
Nucleic acid amplification test(NAAT) |
|
|
Atrophic Vaginitis | Normal | Vaginal smear cytology shows increased parabasal cells | Leftward shift of the vaginal maturation index |
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|