Vaginal discharge

Jump to navigation Jump to search


For patient information, click here

WikiDoc Resources for Vaginal discharge

Articles

Most recent articles on Vaginal discharge

Most cited articles on Vaginal discharge

Review articles on Vaginal discharge

Articles on Vaginal discharge in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Vaginal discharge

Images of Vaginal discharge

Photos of Vaginal discharge

Podcasts & MP3s on Vaginal discharge

Videos on Vaginal discharge

Evidence Based Medicine

Cochrane Collaboration on Vaginal discharge

Bandolier on Vaginal discharge

TRIP on Vaginal discharge

Clinical Trials

Ongoing Trials on Vaginal discharge at Clinical Trials.gov

Trial results on Vaginal discharge

Clinical Trials on Vaginal discharge at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Vaginal discharge

NICE Guidance on Vaginal discharge

NHS PRODIGY Guidance

FDA on Vaginal discharge

CDC on Vaginal discharge

Books

Books on Vaginal discharge

News

Vaginal discharge in the news

Be alerted to news on Vaginal discharge

News trends on Vaginal discharge

Commentary

Blogs on Vaginal discharge

Definitions

Definitions of Vaginal discharge

Patient Resources / Community

Patient resources on Vaginal discharge

Discussion groups on Vaginal discharge

Patient Handouts on Vaginal discharge

Directions to Hospitals Treating Vaginal discharge

Risk calculators and risk factors for Vaginal discharge

Healthcare Provider Resources

Symptoms of Vaginal discharge

Causes & Risk Factors for Vaginal discharge

Diagnostic studies for Vaginal discharge

Treatment of Vaginal discharge

Continuing Medical Education (CME)

CME Programs on Vaginal discharge

International

Vaginal discharge en Espanol

Vaginal discharge en Francais

Business

Vaginal discharge in the Marketplace

Patents on Vaginal discharge

Experimental / Informatics

List of terms related to Vaginal discharge

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

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.Also there is normal vaginal discharge depends on periodic hormonal change[1]

Causes

Common Causes

Classification

Normal vaginal discharge as in Neonatal, Pediatric, Puberty, Menstrual cycle[7], Pregnancy, and Menopause. -Abnormal vaginal discharge as

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

'Abbreviations: QHS : Every bedtime , BID: 2 times daily, TID: Three times a day, QID: Four times a day, IM :Intramuscular


Organisms Recommended Drugs Alternative drugs
Candidiasis

Over-the-Counter Intravaginal Agents[8]

  • Clotrimazole 1% cream 5 g intravaginally daily for 7–14 days

OR

OR

  • Miconazole 2% cream 5 g intravaginally daily for 7 days

OR

  • Miconazole 4% cream 5 g intravaginally daily for 3 days

OR

OR

OR

OR


Prescription Intravaginal Agents:


  • Butoconazole 2% cream (single dose bioadhesive product), 5 g intravaginally in a single application

OR

  • Terconazole 0.4% cream 5 g intravaginally daily for 7 days

OR

  • Terconazole 0.8% cream 5 g intravaginally daily for 3 days

OR


Oral Agent:



Nystatin 1,00,000 unit tab vaginally QHS for 2 weeks[9]

Trichomoniasis

OR


OR

Bacterial Vaginosis

OR

  • Metronidazole gel 0.75%, one full applicator (5 g) intravaginally, once a day for 5 days[11]

OR

  • Clindamycin cream 2%, one full applicator (5 g) intravaginally at bedtime for 7 days[11]

OR

OR

OR

Neisseria gonorrhoea


Amoxicillin orally 3 gm single dose
or
Ampicillin orally 3.5 gm single dose
or
Procaine PCN G 4.8 million IM single dose [9]


PLUS


Probenecid 1 gm orally single dose [9]


AND


Tetracycline 500 mg orally QID for 7 days
or
Doxycycline 100 mg orally BID for 7 days
or
Ceftriaxone 250 mg IM single dose[9]

Erythromycin 500 mg orally QID for 7 days[9]
or
Tetracycline 500 mg orally QID for 7 days[9]
or
Doxycycline 100 mg orally BID for 7 days[9]
or
Spectinomycin 2 gm IM single dose

Chlamydia trachomatis

Tetracycline 500 mg orally QID for 7 days[9]
or
Doxycycline 100 mg orally BID for 7 days[9]

Erythromycin base 500 mg orally QID for 7 days[9]
or
Erythromycin ethylsuccinate 800 mg orally QID for 7 days[9]
or
Sulfamethoxazole 1gm orally BID for 10 days

Herpes Simplex


Acyclovir[9]


Patient should be referred to a gynecologist if following are present. [12]

Treatment in pregnancy:

Acute pharmacotherapies

Bacterial Vaginosis

Candida and Chlamydia

Gonorrhea

Trichomonas

References

  1. Spence D, Melville C (2007). "Vaginal discharge". BMJ. 335 (7630): 1147–51. doi:10.1136/bmj.39378.633287.80. PMC 2099568. PMID https://www.ncbi.nlm.nih.gov/pubmed/18048541 Check |pmid= value (help).
  2. Hainer BL, Gibson MV (2011). "Vaginitis". Am Fam Physician. 83 (7): 807–15. PMID 21524046.
  3. Cettl L, Dvorak J, Felkel H, Feuereisl R (1979). "Results of simulation of non-homogeneous ventilatory mechanics for a patient-computer arrangement". Int J Biomed Comput. 10 (1): 67–74. doi:10.1016/0020-7101(79)90042-4. PMID http://www.ncbi.nlm.nih.gov/pmc/articles/pmc478688 Check |pmid= value (help).
  4. 4.0 4.1 4.2 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1016/j.ogrm.2016.08.002 Check |pmid= value (help).
  5. Wathne B, Holst E, Hovelius B, Mårdh PA (1994). "Vaginal discharge--comparison of clinical, laboratory and microbiological findings". Acta Obstet Gynecol Scand. 73 (10): 802–8. doi:10.3109/00016349409072509. PMID https://pubmed.ncbi.nlm.nih.gov/7817733 Check |pmid= value (help).
  6. Spence D, Melville C (2007). "Vaginal discharge". BMJ. 335 (7630): 1147–51. doi:10.1136/bmj.39378.633287.80. PMC 2099568. PMID https://pubmed.ncbi.nlm.nih.gov/18048541 Check |pmid= value (help).
  7. Feingold KR, Anawalt B, Boyce A, Chrousos G, Dungan K, Grossman A; et al. (2000). "Endotext". PMID https://pubmed.ncbi.nlm.nih.gov/25905282 Check |pmid= value (help).
  8. 8.0 8.1 "Vulvovaginal Candidiasis - 2015 STD Treatment Guidelines".
  9. 9.00 9.01 9.02 9.03 9.04 9.05 9.06 9.07 9.08 9.09 9.10 9.11 Watson WJ, Demarchi G (August 1987). "Vaginal discharge: an approach to diagnosis and management". Can Fam Physician. 33: 1847–52. PMC 2218224. PMID 21263805.
  10. 10.0 10.1 10.2 10.3 10.4 "Trichomoniasis - 2015 STD Treatment Guidelines".
  11. 11.0 11.1 11.2 11.3 11.4 11.5 11.6 11.7 "Bacterial Vaginosis - 2015 STD Treatment Guidelines".
  12. Sim, M; Logan, S; Goh, LH (2020). "Vaginal discharge: evaluation and management in primary care". Singapore Medical Journal: 297–301. doi:10.11622/smedj.2020088. ISSN 0037-5675.

Template:Skin and subcutaneous tissue symptoms and signs Template:Nervous and musculoskeletal system symptoms and signs Template:Urinary system symptoms and signs Template:Cognition, perception, emotional state and behaviour symptoms and signs Template:Speech and voice symptoms and signs Template:General symptoms and signs

Template:WikiDoc Sources