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Journal article
Management of Persistent Vaginitis
Obstetrics and gynecology (New York. 1953), v 124(6), pp 1135-1146
01 Dec 2014
PMID: 25415165
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
With vaginitis remaining a common condition that leads women to seek care, it is not surprising that some women develop chronic vulvovaginal problems that are difficult to diagnose and treat. With a differential diagnosis that encompasses vulvar disorders and infectious and noninfectious causes of vaginitis, accurate diagnosis is the cornerstone of choosing effective therapy. Evaluation should include a symptom-specific history, careful vulvar and vaginal examination, and office-based tests (vaginal pH, amine test, saline and 10% potassium hydroxide microscopy). Ancillary tests, especially yeast culture with speciation, are frequently crucial to obtaining a correct diagnosis. A heavy but normal physiologic discharge can be determined by excluding other causes. With vulvovaginal candidiasis, differentiating between Candida albicans and non-albicans Candida infection has important treatment ramifications. Most patients with C albicans infections can be successfully treated with maintenance antifungal therapy, usually with fluconazole. Although many non-albicans Candida, particularly Candida glabrata, may at times be innocent bystanders, vaginal boric acid therapy is an effective first choice for many true non-albicans Candida infections. Recurrent bacterial vaginosis, a difficult therapeutic challenge, can often be controlled with maintenance therapy. Multiple options, especially high-dose tinidazole, have been used for metronidazole-resistant trichomoniasis. With the aging of the U.S. population, atrophic vaginitis and desquamative inflammatory vaginitis, both associated with hypoestrogenism, are encountered frequently in women with persistent vaginitis.
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Details
- Title
- Management of Persistent Vaginitis
- Creators
- Paul Nyirjesy - Drexel University
- Publication Details
- Obstetrics and gynecology (New York. 1953), v 124(6), pp 1135-1146
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 12
- Grant note
- Becton-Dickinson Symbiomix Novadigm Viamet Pharmaceuticals
- Resource Type
- Journal article
- Language
- English
- Web of Science ID
- WOS:000345341100011
- Scopus ID
- 2-s2.0-84916911991
- Other Identifier
- 991019350590204721
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- Web of Science research areas
- Obstetrics & Gynecology