Other Forms of Vaginitis

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Aerobic vaginitis is characterized by purulent vaginal discharge with a dominant abnormal aerobic flora. Patients experience a foul-smelling nonfishy discharge, and examination may reveal erythema, inflammation, and ulcers of the posterior fornix. Although culture is the gold standard, the diagnosis is usually one of exclusion, with pH greater than 6.0, white blood cells (WBCs) on microscopy, and absence

Image Dried Seminal Stain

Figure 25-3 Trichomoniasis. Trichomonads are seen under high-power magnification in a wet mount prepared with physiologic saline. Usually, more immature epithelial cells are seen in the secretions of active trichomoniasis. (From Kaufman RH, Faro S. Benign Disease of the Vulva and Vagina, 4th ed. St Louis, Mosby, 1994.)

Figure 25-3 Trichomoniasis. Trichomonads are seen under high-power magnification in a wet mount prepared with physiologic saline. Usually, more immature epithelial cells are seen in the secretions of active trichomoniasis. (From Kaufman RH, Faro S. Benign Disease of the Vulva and Vagina, 4th ed. St Louis, Mosby, 1994.)

of hyphae or clue cells. Treatment with topical clindamycin has a good response (French et al., 2004). The addition of a topical estrogen may increase treatment success.

Irritant and allergic vaginitis should be considered in the differential diagnosis of vaginal complaints. Common etiologies include spermicidal products, douching solutions, diaphragms, latex condoms, and topical medications. The treatment is discontinuation of intravaginal products (French et al., 2004).

Cytolytic vaginitis is caused by an overgrowth of lactobacilli and cytolysis of squamous epithelial cells. Although it may be related to intravaginal products or other medication use, its etiology remains unclear. It can mimic VVC with a white, curdled-cheese discharge, and the pH range is typically 3.5 to 5.5. Treatment is discontinuation of intravaginal medications. Baking soda douches or sitz baths have been used, but minimal data exist to support this recommendation (French et al., 2004).

Desquamative inflammatory vaginitis (DIV) is characterized by copious purulent discharge with squamous epithelial cell exfoliation. The etiology is unclear but likely multifactorial. Some cases may be linked to lichen planus spectrum. Laboratory evaluation reveals a negative wet mount, KOH, and cultures. Treatment options include a trial of local or systemic cortico-steroids (French et al., 2004) or clindamycin suppositories.

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Bacterial Vaginosis Facts

Bacterial Vaginosis Facts

This fact sheet is designed to provide you with information on Bacterial Vaginosis. Bacterial vaginosis is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina.

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