Friday, March 10, 2017

Differential of Vaginitis



Bacterial Vaginosis from Gardnerella, Rx: (Metronidazole, 500 mg twice daily PO x 7d or Flagyl ER 750 mg PO once daily x 7d.), no need to Rx sexual partner.

See Candida profile, aka Yeast infection, extremely common. Rx: Terazole (Terconazole), etc. No need to Rx sexual partner.

See Trichomonas profile. Rx: (Metronidazole, single 2 gm x 1 dose or 500 mg PO twice-daily x 7 d (more effective).), and rx the sexual partner.

See Chlamydia Profile (often asymptomatic, may be redness and irritation, clear discharge): Azithromycin + Doxycycline, and rx the sexual partner.

If past menopause, also consider atrophic physiological dryness. Consider topical or oral estrogen, even BCP.

Need to do wet mount:


(note the flagellum on Trichomonas organism around 10 o'clock above the word "Yeast".)

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