Vulvovaginitis: Difference between revisions

Revision as of 23:58, 7 March 2014

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

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

Tintinalli

Authors:

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 ==Differential Diagnosis==
 *[[Bacterial Vaginosis]]
+*[[Candida Vaginitis]]
-==[[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]]==