Vaginal Discharge Syndrome (VDS)
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VDS refers to change of colour, odour and/or amount of vaginal secretions.
Causes
- T. vaginalis
- C. albicans
- Bacterial Vaginosis
- Neisseria gonorrhoeae
- Chlamydia trachomatis
Clinical Presentation
- Abnormal vaginal discharge
- Burning or painful micturition
- Itchy vulva
- Increased frequency and urgency of micturition and/or painful coitus
Note:
- A spontaneous complaint of abnormal vaginal discharge is most commonly due to a vaginal infection
- T. vaginalis, C. albicans and Bacterial Vaginosis are the commonest causes of vaginal infection
- Neisseria gonorrhoeae and Chlamydia trachomatis cause cervical infection.
- The clinical detection of cervical infection is difficult because a large proportion of women with gonococcal or chlamydia infections are asymptomatic
- Vaginal discharge is therefore highly indicative of vaginal infection, but poorly predictive for cervical infection
- Due to the high prevalence of gonorrhea and chlamydia, all women presenting with VDS should receive treatment for both vaginal and cervical infections
- Delayed or inadequate treatment of VDS may result to endometritis, salpingitis, oophoritis or ectopic pregnancy.
- Gonococcal or chlamydial cervical infection may be asymptomatic
Investigation(s) if the HF has a Laboratory capable of doing:
- Wet preparation
- Gram stain
- Culture and Sensitivity
- Fluorescent Microscopy
- Pap test (Papanicolau test)
- ELISA
- Quantitative or qualitative PCR
- NB starts simple to complex
Management and Treatment of VDS (see flow chart 12.2)