Vaginitis / Leukorrhea

Inflammation and/or infection of the vagina with possible concurrent inflammation of the vulva. Vaginitis typically occurs one of two ways:

1. The overgrowth of a normal part of the vaginal flora, or the introduction of a foreign microorganism through sexual relations.

• Normal flora that can cause disease: yeast (often Candida albicans) may also spread from the intestines

or sexually; Hemophilus vaginalitis/Gardnerella vaginalitis: often called "nonspecific vaginitis."

• Foreign microorganisms: Trichomonas vaginalitis, Neisseria gonorrhea.
• In young girls it may be also caused by E. coli, strep, or staph due to poor hygiene.

2. Reaction to an external agent causing allergic or chemical reaction.

Signs and Symptoms

• Vaginal discharge: white and curdish (yeast); creamy white or off-white (Gardnerella); greenish-yellow, frothy (Trichomonas).
• Itching: may be severe.
• Odor: None (yeast and Trichomonas); fishy (Gardnerella).
• Vulvar irritation and redness: possible with all three infections; however, Candida is typically the worst irritant and can cause fissuring and swelling.
• Vagina: normal except for the presence of mild to extreme amounts of discharge.
• Lab Findings: (+) Wet prep and/or culture for microorganism identification. Pap smear may show inflammatory signs.

Course and Prognosis

While Trichomonas, Candida, and Gardnerella are benign infections causing no severe or life-threatening pathology, they can cause significant and unrelenting morbidity. Trichomonas, in particular, should be treated in a sexually active woman to prevent her passing it on to other individuals. Conventional treatment usually consists of nystatin (yeast); metronidazole (Trichomonas), and oxytetracycline (Hemophilus). Women treated this way have a high recurrence rate (especially of yeast and Hemophilus).

Differential Diagnosis

• Differentiate infectious cause
• Foreign body (forgotten tampon)
• Malignancy
• Differentiate allergic/irritant cause