Approach to females with symptoms of vaginitis

InfectionSTD?FeaturesTreatmentTreat Partner?
Bacterial
Vaginosis
Very
unlikely
Milky white
Thin discharge,
CLUE cells,
FISHY odor.
Metronidazole 500mg PO BID X7d or

Metronidazole gel daily X 5d or

Clindamycin cream daily X 7d
NO
CandidaNOWhite
Thick discharge,
Cottage cheesy,
Burns, Itches,
No bad smell.
Fluconazole 150mg X 1 or

Clotrimazole topical X 3-7d [pregnancy]
NO if no symptoms
TrichomonasYESThin green-yellow discharge, vulvovaginal erythema,
Malodorous,
burns, post-coital bleeding, dyspareunia, dysuria.
Metronidazole 2g X1 or
Tinidazole 2g X1
YES

Bacterial vaginosis is FISHY but it gives CLUE.

Trichomonas treatment is tricky as it needs partner treated.

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