Common Genital Symptoms and their Non-STI Causes Flashcards
Microbial causes of genital symptoms
Candida
Bacterial vaginosis
Balanoposthitis
Non microbial causes of genital symptoms
Dermatoses Trauma Cancer Neuromuscular ‘Hypervigilance’ Iatrogenic Idiopathic
Presenting complaints
Discharge from an orifice Pain from somewhere Rashes Lumps and swellings Cuts, sores, ulcers Itching Change in appearance
Microbial conditions not regarded as STDs
Vulvovaginal candidosis Bacterial vaginosis Balanoposthitis – anaerobic/candidal Tinea cruris Erythrasma Infected sebaceous glands Impetigo Cellulitis
What is the most common causative organism for vulvovaginal candidosis?
Candida albicans
can be C. glabrata et al.
How is vulvovaginal candidosis usually acquired?
From bowel
If symptomatic, what are the symptoms of vulvovaginal candidosis?
“Thrush”
Itch
Discharge – classically thick, ‘cottage cheese’ but often just a report of increased amount
When is vulvovaginal candidosis more likely to happen
Diabetes Oral steroids Immune suppression incl HIV Pregnancy Reproductive age group
Examination findings of vulvovaginal candidosis
Fissuring
Erythema with satellite lesions
Characteristic discharge
Treatment of vulvovaginal candidosis
Azole antifungals
Maintain skin - avoid irritants, treat dermatitis
Azole antifungals
Clotrimazole
Fluconazole
What is the commonest cause of vaginal discharge?
Barcterial vaginosis
Symptoms of bacterial vaginosis
Asymptomatic in 50%
Watery grey/yellow ‘fishy’ discharge
May be worse after period / sex
Sometimes sore/itch from dampness
Factorial cause of bacterial vaginosis
Reduction of lactobacilli (reduction in H2O2 production) <=> raised pH <=> overgrowth of BV associated bacteria <=> (reduction of lactobacilli)
Diagnosis of BV
Characteristic history
Examination findings (thin, homogenous discharge)
pH
Gram stained smear of vaginal discharge
