Friday, February 26, 2016

A 19 Year Old Woman Presenting With A Vaginal Discharge



A 19-year-old nulliparous woman presents to her gynecologist with the complaint of a vaginal discharge with a fishy odor over the past 2 weeks. The patient is sexually active and states that the odor is especially prominent after intercourse. Her last menstrual period was 3 weeks ago. She denies having any history of sexually transmitted diseases. She is in good health and takes no medications other than an oral contraceptive agent.
On examination, her blood pressure (BP) is 110/70 mm Hg, heart rate (HR) is 80 beats per minute, and temperature is afebrile. The thyroid is normal to palpation. The heart and lung examinations are normal. The external genitalia are normal; the speculum examination reveals a homogeneous, white vaginal discharge and a fishy odor. No erythema or lesions of the vagina are noted.

1.  What is the most likely diagnosis?
2. What is the best treatment for this condition?

Answer And Discussion:


1.  What is the most likely diagnosis?

Answer: Most likely diagnosis is Bacterial vaginosis.

Discussion:  Avaginal discharge that has a fishy odor, is the most common symptom of bacterial vaginosis. The discharge associated with BV has a typical white, homogenous vaginal coating, described like “spilled milk over the tissue.” The pH is not given in this scenario and although a whiff test was not performed with KOH in this patient, the worsening of the discharge after intercourse is presumably due to the alkaline semen. The vaginal epithelium is not erythematous or inflamed, which also fits with bacterial vaginosis.
Of the three most common causes of infectious vaginal discharge (Candida, Trichomonas, and BV),
bacterial vaginosis is the only etiology that is not inflammatory.

2. What is the best treatment for this condition?

Answer: Best treatment for this condition: Metronidazole orally or vaginally; clindamycin is an alternative.

Discussion: Bacterial Vaginosis is a result of a predominance of anaerobic bacteria rather than a true infection. Hence, antibiotic therapy targeting anaerobes, such as metronidazole or clindamycin, is appropriate.

4 comments:

  1. I want every herpes patient to please read my testimony, my name is SARAH MORGAN am from California in USA, I contacted genital herpes from my ex boyfriend who never had any symptoms. I have had it for 4 months now., and it has affected my life. I have told my boyfriends who I trusted about it and I have never had a bad reaction, it has affected my new relationships with Smith and people think herpes is really a minor skin irritation herpes has a long term effects on health. The stigma attached to this virus by ignorant people is ridiculous. Most people have herpes in one form or another. I would like to advise people on how I get rid of my herpes and I was reading a comment on the internet,and I saw a testimony posted by a woman from Germany that she get rid of her herpes with the help of DR AHKIGBE and so I was so happy when I saw that post, that his herbal medication is free and I quickly collected the herbal doctor email and I email him within 3 hr he respond to my email and I explain things to him he told me not to worry that he is going to cure me totally with his herbal medicine he only request for little money that he will use to buy the items for the preparation of the herbal medicine, wish I send to him because the pain was too much for me to bear and after some days he told me that he has prepare the herbal medicine, that I should send him my address that he want to sent it to me via DHL or FED-EX that was how I got the herbal medication and I use it as I was told and after few days I found out that my herpes was no more, i went to hospital for confirmation and it was true really that was how i got my cured. DR AKHIGBE also cure other deadly diseases like,  HIV/AIDS, HERPES, DIABETES,CANCER, ALS, ASTHMA, HERPAPITIS A&B, DENGUE FEVER, RABIES, MARBURG DISEAS, THYROID, MENINGITIS ,LUPUS, EPILEPSY, CHRONIC DISEASE, MALARIA, BACTERIAL DIARRHEA HEART DISEASE., JOINT PAIN, STOMACH PAIN, SCHIZOPHRENIA, POLIO,MULTIPLES SCLEROSIS, HIGH BLOOD PRESURE, VAGINAL  DISCHARGE,  TUBERCULOSIS, ALZHEIMER , PENIS ENLARGEMENT, PARKINSON'S, to get your rid kindly via his email:   drrealakhigbe@gmail.com    contact his number:  +2349010754824           website:  https://drrealakhigbe.weebly.com       you can still write me on Instagram to get more information. on Sarah Morgan.

    ReplyDelete
  2. Safe Hands Clinic- if you are looking for PEP Treatment for HIV, PEP Treatment in Delhi, Then Dr Vinod Raina is Best for You. HIV Can Be Cure By PEP Treatment. People with HIV don't usually have symptoms right away, so they may not know they have it. HIV treatment in Delhi, HIV Symptoms, HIV Cure, HIV AIDS, Aids Treatment, Aids Symptoms, Aids Cure, HIV AIDS Symptoms, Post Exposure Prophylaxis, causes of HIV, HIV Testing near Me, HIV Test Cost, PEP for HIV Treatment. https://www.hivdoctorsindelhi.com/

    Call Now: +91-9871605858, 9136363692

    ReplyDelete
  3. Very significant Information for us, I have think the representation of this Information is actually superb one. This is my first visit to your site. Vaginal discharge

    ReplyDelete
  4. European University is formerly known as European Teaching University one of the top recognized universities with an established status of Educational University in Georgia. European University is acknowledged by most Accreditation agencies of the world for its higher education programs organized in accordance with all the rules and regulations of World Accreditation Agencies. Since Inception University is absolutely fixated on promoting a sustainable developed environment to provide creative and personally enriched international educational standards to its students.

    ReplyDelete