Noncandidal vaginitis: a comprehensive approach to diagnosis and management

Neal, Chemen M.; Kus, Lauren H.; Eckert, Linda O.; Peipert, Jeffrey F.

doi:10.1016/j.ajog.2019.09.001

Cited by 40 publications

(38 citation statements)

References 67 publications

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“…These included one prospective cohort study, 73 two comparative studies, 74,75 one retrospective cohort study, 76 five cross‐sectional studies, 77–81 one qualitative study, 82 and one literature review 83 . We further extrapolated treatment strategies from expert reviews on standard clinical evaluation and treatment that could be used in telemedicine 84–86 …”

Section: Resultsmentioning

confidence: 99%

“… ●Although telephone diagnosis of vulvovaginal complaints is poor, 74,76,83 bacterial vaginosis, candidiasis, and trichomonas are the most common causes of vulvovaginal symptoms; thus, it is reasonable to start with empiric treatment if these are suspected (EC). ○Overall, the treatment for these three infections is benign and can often be treated with a single dose of medication (EC). ○If there is inadequate response to treatment, then it could be appropriate to schedule an in‐person visit, depending on the severity of symptoms (EC). ●If vulvar irritation is present, there should be a strong suspicion of a secondary infection such as candidiasis or other inflammatory processes 84 ●For patients with hypoestrogenism, vaginal estrogen could be started empirically for vulvovaginal irritation/itching (EC). …”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Guidance for gynecologists utilizing telemedicine during COVID‐19 pandemic based on expert consensus and rapid literature reviews

Grimes

Balk

Dieter

et al. 2020

Intl J Gynecology & Obste

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Background: COVID-19 has impacted delivery of outpatient gynecology and shifted care toward use of telemedicine. Objective: To rapidly review literature and society guidelines and create expert consensus to provide guidance regarding management of outpatient gynecology scenarios via telemedicine. Search strategy: Searches were conducted in Medline and Cochrane databases from inception through April 15, 2020. Selection criteria: Literature searches were conducted for articles on telemedicine and abnormal uterine bleeding, chronic pelvic pain, endometriosis, vaginitis, and postoperative care. Searches were restricted to available English language publications. Data collection and analysis: Expedited literature review methodology was followed and 10 943 citations were single-screened. Full-text articles and relevant guidelines were reviewed and narrative summaries developed. Main results: Fifty-one studies on the use of telemedicine in gynecology were found. Findings were reported for these studies and combined with society guidelines and expert consensus on four topics (abnormal uterine bleeding, chronic pelvic pain and endometriosis, vaginal discharge, and postoperative care). Conclusions: Guidance for treating gynecological conditions via telemedicine based on expedited literature review, review of society recommendations, and expert consensus is presented. Due to minimal evidence surrounding telemedicine and gynecology, a final consensus document is presented here that can be efficiently used in a clinical setting.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Guidance for gynecologists utilizing telemedicine during COVID‐19 pandemic based on expert consensus and rapid literature reviews

Grimes

Balk

Dieter

et al. 2020

Intl J Gynecology & Obste

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“…Although pelvic examinations are routinely performed for women in the ED with genital concerns, the examination itself has questionable utility in helping to diagnose STIs [2][3][4]. However, pelvic examination and vaginal wet preparation (hereafter called wet prep) can be helpful for establishing a cause for vulvovaginal symptoms, which is an irritation or inflammatory condition of the vagina that can present with an associated odor, itching, and swelling [5,6]. Bacterial vaginosis (BV), vulvovaginal candidiasis, and Trichomonas vaginalis infection, in order of decreasing frequency, account for about 70% to 90% of vaginitis causes [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…However, pelvic examination and vaginal wet preparation (hereafter called wet prep) can be helpful for establishing a cause for vulvovaginal symptoms, which is an irritation or inflammatory condition of the vagina that can present with an associated odor, itching, and swelling [5,6]. Bacterial vaginosis (BV), vulvovaginal candidiasis, and Trichomonas vaginalis infection, in order of decreasing frequency, account for about 70% to 90% of vaginitis causes [5][6][7][8]. Other causes include desquamative inflammatory vaginitis, aerobic vaginitis, vaginal erosive disease, and atrophic vaginitis [5,6,9].…”

Section: Introductionmentioning

confidence: 99%

Frequency of Coinfection on the Vaginal Wet Preparation in the Emergency Department

Elkins

Cantillo-Campos

Sheele

2020

Cureus

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Introduction Vaginal infections are common in the emergency department (ED) but the frequency of vaginal coinfections identified on wet preparation is unknown. Methods The study examined a data set of 75,000 ED patient encounters between April 18, 2014, and March 7, 2017, who had received testing for gonorrhea, chlamydia, or trichomonas or had received a urinalysis and urine culture during the ED encounter. From this data set we reviewed 16,484 patient encounters where a vaginal wet preparation was performed on women age 18 years and older. Findings from the vaginal wet preparation and ED discharge diagnoses were examined to evaluate the frequency of vaginal coinfections with vulvovaginal candidiasis, trichomoniasis, and bacterial vaginosis. Results Among the women who had wet preparations, 4,124 patient encounters (25.0%) had a diagnosis of bacterial vaginosis, 625 (3.8%) had a diagnosis of vulvovaginal candidiasis, and 1,802 (10.9%) were infected with Trichomonas vaginalis. Twenty encounters (0.1%) had a diagnosis of vulvovaginal candidiasis and trichomoniasis; 150 (0.9%), bacterial vaginosis and trichomoniasis; 136 (0.8%), vulvovaginal candidiasis and bacterial vaginosis; and 10 (0.1%), trichomoniasis, bacterial vaginosis, and vulvovaginal candidiasis. On vaginal wet preparation, the mean white blood cell count was 13.0 per high-power field. Clue cells were found in 6,988 wet preparations (42.4%); 1,065 wet preparations (6.5%) had yeast and 1,377 (8.4%) had T. vaginalis. T. vaginalis was identified in 2.5% (266/10,542) of urinalyses and 8.4% (406/4,821) of nucleic acid amplification tests. Conclusions Vaginal coinfections were uncommon among women receiving a vaginal wet preparation in the emergency department. The most common vaginal coinfection was bacterial vaginosis and trichomonas.

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“…Proper diagnosis and appropriate management of vaginal discharge is based on the clinical examination and laboratory investigations. 2 Pathological vaginal discharge commonly occurs due to organismal infections of vagina such as Bacterial vaginosis (BV), Trichomonas vaginalis (TV) and Vulvovaginal candidiasis (VVC), which is also known as "vaginal candidiasis" or "candidal vaginitis. "…”

Section: Introductionmentioning

confidence: 99%

Is vaginal discharge a natural or pathological problem in pregnant women associated with adverse pregnancy outcomes?: A cross-sectional study

Khaskheli¹,

Baloch²,

Baloch³

et al. 2020

Preprint

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Objective: To differentiate between normal and pathological vaginal discharge (PVD) in pregnant women and to identify causes of and adverse pregnancy outcomes associated with PVD. Design: A cross-sectional study. Setting: Outpatient antenatal clinics. Population / Sample: Pregnant women, Convenience sample (N=85). Methods: Data were collected through history, clinical examination and laboratory investigations. Data analysed by frequencies, descriptive statistics and Chi-Squared tests. Main outcome measures: Vaginal discharge (VD), age, gestation, parity and adverse pregnancy outcomes. Results: Women's mean age was 27.4 (±4.67) years. Majority of women were 26-31 years old (40%), 28-35 weeks pregnant (34%) and primigravida (41%). Of 89% (n=76) women with VD, 32% (n=24) had normal VD and 68% (n=52) PVD. Normal VD was watery (100%) and odourless (96%) while PVD was yellowish curd like (33%) and foul smelling (52%). PVD was significantly associated with bacterial vaginosis (P < 0.0001), candidiasis (P = 0.005) and trichomoniasis (P = 0.018). A higher proportion of women with PVD reported irritation (P < 0.0001), pain (P < 0.0001), uterine contractions (P < 0.0001), premature membrane rupture (P < 0.0001), abortion (P < 0.042), pre-term delivery (P < 0.0001) and post-partum endometritis (P < 0.0001). PVD was also associated with low birth weight (P < 0.0001), low Apgar score at birth (P < 0.0001), respiratory distress syndrome (P < 0.0001), intensive neonatal care hospitalisation (P = 0.001) and early neonatal death (P = 0.002). Conclusions: Vaginal discharge in pregnancy requires early investigation to avoid any adverse fetomaternal outcomes associated with pathological vaginal discharge.

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Noncandidal vaginitis: a comprehensive approach to diagnosis and management

Abstract: This article presents a comprehensive description of the causes, evaluation, and treatment of non-candidal vaginitis.

Cited by 40 publications

References 67 publications

Guidance for gynecologists utilizing telemedicine during COVID‐19 pandemic based on expert consensus and rapid literature reviews

Guidance for gynecologists utilizing telemedicine during COVID‐19 pandemic based on expert consensus and rapid literature reviews

Frequency of Coinfection on the Vaginal Wet Preparation in the Emergency Department

Is vaginal discharge a natural or pathological problem in pregnant women associated with adverse pregnancy outcomes?: A cross-sectional study

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