sample patient case report with vaginal discharge due tosti

Can a vaginal discharge be sent to a lab?

In most local primary care settings, an in-house microscope may not be available, and specimens of vaginal discharge for investigations must be sent to an external laboratory. If a lower genital tract infection is suspected, point-of-care testing can aid diagnosis based on the pH levels of the discharge.

What are the non-infectious causes of vaginal discharge?

Non-infectious causes include atrophic vaginitis, contact dermatitis due to allergic or irritant causes, foreign body vaginitis (e.g. retained tampon or condom), cervical polyps, fistulas and genital tumours (e.g. tumours of the vulva, vagina, cervix, fallopian tube and endometrium).(3) A diagnostic aid to vaginal discharge

What are the results of a discharge examination?

Discharge examination revealed negative HEENT, neck, heart, lung, extremities and abdominal examinations. CONDITION ON DISCHARGE: Stable. DISPOSITION: Discharged to home. ACTIVITY: Slow increase as tolerated. No heavy lifting. Strict pelvic rest. DIET: Regular. MEDICATIONS: Colace p.r.n., Tylenol p.r.n. and prenatal vitamins.

What is the prevalence of normal and abnormal vaginal discharge?

Normal vaginal discharge is found in 10% of those who present with vaginal discharge.(4) Abnormal vaginal discharge

What are the major causes of abnormal vaginal discharges?

The major causes of abnormal vaginal discharge are either vaginal or cervical infections. Causes of vaginal infections are Gardnerella vaginalis, Trichomonas vaginalis, and Candida albicans. Primary cervical infections causing vaginal discharge are Neisseria gonorrhoeae, Chlamydia trachomatis, and Herpes simplex.

Is vaginal discharge a diagnosis?

How is vaginal discharge diagnosed? If your vaginal discharge increases, changes color or odor, or is suddenly itchy or irritated, see your doctor. You may have a yeast infection, bacterial vaginosis, or trichomoniasis. Your doctor will need to examine you to make a diagnosis.

What kind of discharge do you have with chlamydia?

Chlamydia bacteria often cause symptoms that are similar to cervicitis or a urinary tract infection (UTI). You may notice: White, yellow or gray discharge from your vagina that may be smelly. Pus in your urine (pyuria).

What is physiological vaginal discharge?

Discharge from the vagina is common and often normal in women. Sometimes this is called a 'physiological discharge'. Physiological discharge contains cleansing bacteria (called lactobacilli) which help to prevent some infections.

How do you evaluate vaginal discharge?

The use of narrow-spectrum pH paper as a point-of-care tool, if available, can help with the assessment of vaginal infection. High vaginal swabs for microscopy (wet mount and Gram stain), culture and sensitivity should be considered in those with chronic or recurrent presentations.

How much vaginal discharge is normal?

How much discharge is normal? The average amount of discharge is 1 teaspoonful per day.

What Colour is chlamydia discharge?

So, what does a chlamydia discharge look like? A chlamydia discharge is often yellow in color and has a strong odor. A symptom that frequently co-occurs with this discharge is painful urination that often has a burning sensation in the genital area.

How long does chlamydia discharge last?

Discharge or pain when you urinate should improve within a week. Bleeding between periods or heavier periods should improve by your next period. Pelvic pain and pain in the testicles should start to improve quickly but may take up to two weeks to go away.

What does chlamydia discharge smell like?

What does chlamydia discharge smell like? Chlamydia discharge usually has a strong, foul smell. The odour of chlamydia discharge in women is sometimes said to be fishy, or similar to the smell of pus.

What color is normal vaginal discharge?

Normal vaginal discharge is milky or white and is odorless. But sometimes, an imbalance of bacteria in your vagina can cause your discharge to change color.

What are the differential diagnosis for vaginal discharge?

Differential Diagnosis Other causes of vaginal discharge include atrophic vaginitis, retained foreign body, cytolytic vaginitis, desquamative inflammatory vaginitis, genital herpes, physiologic discharge, and perhaps gonorrhea or chlamydia.

What kind of discharge is concerning?

If you suddenly have much more vaginal fluid than you normally do, it may be a sign of a problem. Color is also important. Bright yellow or green discharge could be a concern. Thick, clumped, or chunky discharge (like cottage cheese) or extra watery discharge can also mean something is amiss.

When should I call the doctor about vaginal discharge?

Schedule a doctor's visit if you have: Greenish, yellowish, thick or cheesy vaginal discharge. Strong vaginal odor. Redness, itching, burning or irritation of your vagina or the area of skin that surrounds the vagina and urethra (vulva)

When should I be concerned about excessive discharge?

You should consult your healthcare provider, within one day, anytime you have symptoms or concerns relating to abnormal vaginal discharge. Especially if it is accompanied by a foul odor or has an abnormal color such as gray, green, or yellow.

What are the most common causes of vaginal discharge?

Clinical features associated with the three most common causes of vaginal discharge.(5,9) Open in a separate window. Cervicitis is another important cause of vaginal discharge, with Chlamydia trachomatisand Neisseria gonorrhoeaebeing the most common pathogens isolated.

Is vaginal discharge a physiologic occurrence?

Vaginal discharge may be a normal physiologic occurrence or a pathological manifestation. In Singapore, we are likely to be underdetecting the number of women with abnormal vaginal discharge in primary care, as it is often viewed as a taboo complaint or embarrassing in Asian cultures.(2) Normal vaginal discharge.

Is fluconazole effective for VVC?

For VVC, the choice of treatment can be based on the woman’s preference, with single-dose oral fluconazole being as effective as topical azoles. However, an exception should be made when the woman is pregnant and the treatment of choice is a topical azole, as oral fluconazole is contraindicated in pregnancy.

Can a microscope be used to test for vaginal infection?

In most local primary care settings, an in-house microscope may not be available, and specimens of vaginal discharge for investigations must be sent to an external laboratory. If a lower genital tract infection is suspected, point-of-care testing can aid diagnosis based on the pH levels of the discharge.

Vital Signs

Thin, soft, non-tender, non-distended, no guarding, no rebound, mild suprapubic tenderness

Laboratory Studies

This patient presents with classic symptoms of trichomonas infection, which include green-yellow frothy discharge, dyspareunia, pruritus, and dysuria. This was most likely transmitted from her new male partner.

Vital Signs

Mucopurulent discharge at the external os, cervix bleeds easily when touched with a cotton swab, no cervical motion tenderness

Laboratory Studies

Based on the patient’s clinical presentation with mucopurulent cervical discharge and endocervical bleeding (friability) with gentle touch, this patient has acute cervicitis. There is no foreign body in the vagina, and the non-tender uterus and adnexae exclude pelvic inflammatory disease.

Vital Signs

Nulliparous, has punctate hemorrhages with a “strawberry cervix” appearance, no cervical motion tenderness

History

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Examination

Questions

Answer

Further Investigation

Management

Bv and Pregnancy