45 years old Lady Symptoms 1. Itching 2. pain and maturation 3. White discharge since 5 months Please diagnose and rx



It is vaginitis.causes of vaginitis include 1.75 percent due to yeast infection.rule out DM . Symptoms Inc curdy white discharge,itcing seen Treatment includes locally vaginal pessaries clinogen forte pessaries. Cap. Candistat 200 mg bd for 2 days. Followed by tab flucanozole 150 mg weekly once. Abstinence. Treatment of sexual partner. Tab ataraxia/ levocetrizine for itcing. As vaginal PH is altered,vagisil wash for local use can be effective. D/D includes bacterial vaginitis greyish white discharge . fishy odour. Treatment in tab metrogyl ,400 mg tid.. Vaginal pessaries of dressing v used. 5.Trichomonas vaginitis yellowish green discharge treatment is with tab . metrogyl 400 mg tid for 5 days. Other causes are viral,environmental. If still not subsiding, go for vaginal swab for C/ S.

Pruritis , dysuria and white discharge Do routine investigations like cbp,esr,rbs and urine routine examination.There is no obvious discharge in the photograph. Start tab terbinafine 500 mg of for 7-10 days. Add tab biovag bd for 7 days. If there is UTI give tab ceftum 250 mg bd for 5 days. If the discharge is curdy,treat as candidiasis with tab clingen vaginal suppositories. If the discharge is purulent,treat as bacterial vaginosis If the discharge is greeny and frothy,it is trichomoniasis.treat with oral ad local metronidazole. If there is diabetes,do basic tests like HbA1C,lft,rft,lipid profile and start treatment.

Vulvo vaginitis .do routine investigation to rule out diabetes

Vulvovaginitis or vaginitis is swelling or infection of the vulva and vagina. Vaginitis is a common problem that can affect women and girls of all ages. Causes Collapse Section Causes has been expanded. INFECTIONS Yeast infections are one of the most common causes of vulvovaginitis in women. Yeast infections are most often due to the fungus Candida albicans. Candida and the many other germs that normally live in the vagina keep each other in balance. However, sometimes the number of candida increases, leading to a yeast infection. Yeast infections often cause genital itching, a thick white vaginal discharge, and other symptoms. The vagina normally contains both healthy bacteria and unhealthy bacteria. Bacterial vaginosis (BV) occurs when more unhealthy bacteria than healthy bacteria grow. BV may cause a thin, gray vaginal discharge and a fishy odor. A less common type of vaginitis is spread by sexual contact. It is called trichomonias. Symptoms in women include genital itching, vaginal odor, and a heavy vaginal discharge that may be yellow-gray or green in color. OTHER CAUSES Chemicals can cause itchy rashes in the genital area. Spermicides and vaginal sponges, which are over-the-counter birth control methods Feminine sprays and perfumes Bubble baths and soaps Low estrogen levels in women after menopause can cause vaginal dryness and thinning of the skin of the vagina and vulva. These factors may lead to or worsen genital itching and burning. Other causes include: Tight-fitting or nonabsorbent clothing, which leads to heat rashes Skin conditions Objects such as a lost tampon can also cause irritation, itching, and strong-smelling discharge. Sometimes, the exact cause cannot be found. This is called nonspecific vulvovaginitis. It occurs in all age groups, but is most common in young girls before puberty, especially girls with poor genital hygiene. It causes a foul-smelling, brownish-green discharge and irritation of the labia and vaginal opening. This condition is often linked with excess growth of bacteria that are typically found in the stool. These bacteria are sometimes spread from the rectum to the vaginal area by wiping from back to front after using the toilet. Irritated tissue is more likely to become infected than healthy tissue. Many germs that cause infection thrive in a warm, damp, and dark environment, which can also lead to a longer recovery. Sexual abuse should be considered in young girls with unusual infections and repeated episodes of unexplained vulvovaginitis. Symptoms Collapse Section Symptoms has been expanded. Symptoms include: Irritation and itching of the genital area Inflammation (irritation, redness, and swelling) of the genital area Vaginal discharge Foul vaginal odor Discomfort or burning when urinating Exams and Tests Collapse Section Exams and Tests has been expanded. If you have been diagnosed with a yeast infection in the past and know the symptoms, you can try treatment with over-the-counter products. However, if your symptoms do not completely disappear in about a week, contact your health care provider. Many other infections have similar symptoms. The provider will perform a pelvic examination. This exam may show red, tender areas on the vulva or vagina. A wet prep (examining vaginal discharge under a microscope) is usually done to identify a vaginal infection or overgrowth of yeast or bacteria. In some cases, a culture of the vaginal discharge may identify the germ that is causing the infection. A biopsy (a test of the tissue) of the irritated area on the vulva may be recommended if there are no signs of infection. Treatment Collapse Section Treatment has been expanded. Creams or suppositories are used to treat yeast infections in the vagina. You can buy most of them without a prescription at drugstores, some grocery stores, and other stores. Follow the directions that came with the medicine you are using. There are many treatments for vaginal dryness. Before treating your symptoms on your own, see a doctor who can find the cause of the problem. If you have BV or trichomoniasis, your provider may prescribe: Antibiotic pills that you swallow Antibiotic creams that you insert into your vagina Other medicines that may help include: Cortisone cream Antihistamine pills to help with itching Be sure to use the medicine exactly as prescribed and follow the instructions on the label. Outlook (Prognosis) Collapse Section Outlook (Prognosis) has been expanded. Proper treatment of an infection is most often very effective.

Thanks for the elaborate explanation

It is vulvovaginitis.visaulise Cx, take swab cervico vaginal gram stain& C/s, take pap's smear. Give candid V pessary for5-7days.urine comlete & C/S. Do sugar profile. Review reports & treat accordingly.



Vaginitis may be due to trichomonas/ mixed vaginitis or post menopausal rule out DM .. treat accordingly,better to choose antibiotics after C/S of vaginal smear n is the 2.symptom u have mentioned pain n maturation??

Vulvovaginitis. Take vaginal swab and urine for culture and sensitivity. Do totsl wbc count, differential count and urine routine microscopy, do fbsl ,ppbsl.

WD & ithing, clinical exam along with the microscopic exm of WD wd settle the diagnosis.Candidiasis and Trichomoniasis usualy dont coexist. Trichomoniasis is better associated with itching so single dose of Tinidazole 2 gm to both partners wd correct the problem along with 3 days abstinance

Vaginitis Doxy Zocon Gynedol Miconazole

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