Common Genital Symptom Syndromes & their Non-STI causes Flashcards
What is the approach to differential diagnosis of people presenting with a range of genital symptoms?
1) What could be causing the symptoms?
- STD’s
- Other microbial problem
- Non-microbial
2) Define if it is an STD or not
3) Is the infecting microbe causing all of the symptoms?
What are the common microbial conditions that are not regarded as STD’s?
1) Vulvovaginal candidosis
2) Bacterial vaginosis
3) Balanoposthitis
4) Tinea cruris
5) Eryhrasna
6) Impetigo
7) Cellulitis
What is the infecting organism in vulvovaginal candidosis and what are the common presenting symptoms?
Candida Albicans - usually acquired from bowel and produces a ‘thrush’, itch and discharge like cottage cheese
What woman are at greater risk of acquiring vulvovaginal candidosis?
- Diabetics
- Those on oral steroids
- Pregnancy
- Being in reproductive age group
How is vulvovaginosis candidosis diagnosed?
- Characteristic history
Examination findings:
- Fissuring
- Eryhtema with satellite lesions
- Characteristic cottage cheese discharge
How is vulvovaginosis albicans treated?
Azole Antifungals - clotrimazole & fluconazole
What is the most common cause of abnormal vaginal discharge amongst woman?
Bacterial vaginosis
What are the common presentations of bacterial vaginosis?
Asymptomatic in 50% cases
Watery grey/yellow ‘fishy’ discharge
Can be worse after period/sex
Sore and itchy due to dampness
What are the complications associated with bacterial vaginosis?
- Endometritis
- Premature labour
- Increased risk of HIV acquisition
How is bacterial vaginosis diagnosed?
Examination findings - thin homogenous discharge
Gram stained smear of vaginal discharge
How is bacterial vaginosis treated?
Metronidazole (oral or vaginal gel)
Clindamycin (vaginal)
