Vaginitis
Terms
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- s/s trich
- pruritis, dysuria, frothy d/c, strawberry cervix, erythematous vulva, 50% asymptomatic
- s/s candida
- pruritis, thick curdy d/c, vulva erythematous c possible lesions fissures, no odor
- s/s BV
- fishy odor (esp after sex); irritation; 50% asymptomatic; frothy homogenous d/c,
- trich microscope
- trichomonads, WBC loaded, pH >4.5
- candida microscope
- pH<4.5, hyphae, mycelia
- BV microscope
- clue cells, dec'd or absent lactobacili, no inc WBC, small G+ cocci on stain
- Dx BV
- 3/4: whiff test, homogenous d/c, clue cells, pH>4.5
- Dx Trich
-
wet mount (50% sensitive): WBC loaded, lactobacilus present, pH > 4.5
Culture is more sensitive - Dx candida
- symptoms (itching, burning, d/c) PLUS wet mount: hyphae, buds, poss inc'd wbcs, normal pH
- candida--what would you prescribe in pregnancy?
- miconazole, cream or suppository PV
- BV tx in preg
- metronidazole, gel or PO
- trich tx in preg
- metronidazole, PO
- Flagyl (aka metronidazole)
- cheap, treats BV & trich in pregnancy, avoid in 1st tri unless benefits outweigh risks, AVOID ETOH, may cause candida infection