Vulvovaginitis

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Vulvovaginitis is an inflammatory condition affecting the vulva and the vagina. The causative organisms include; Candida albicans, Chlamydia trachomatis, Trichomonas vaginalis. Bacterial vaginosis.

Clinical Features Symptoms:

• Vaginal itching
• Burning sensation

Signs:
A watery, thick or mucoid, foul-smelling and yellowish or brown vaginal discharge is sometimes present.

Diagnosis Insert a speculum into the vagina and using a swab take two specimens one from the cervical mucosa for gram stain and culture on Gonococcal media for gonorrhoea, the second for wet mount and microscopy for Candida, Trichomonas.

Complications

• Secondary bacterial infection
• Skin excoriation
• Dermatitis

Treatment

Vaginal Discharge and lower Abdominal Pain	Neisseria gonorrhoeae	Adults: Ciprofloxacin 500mg PO stat Plus Doxycycline 100 bd PO X 7/7	Children: Spectinomycin 40mg/kg IM stat (maximum 2g stat) >8years old Erythromycin 50mg/kg/day in 4 doses for 14 days
		PLUS	Metronidazole 5mg/kg body weight
	Chlamydia Trichomoniasis	Metronidazole 2g PO stat
		PLUS
	Bacterial Vaginosis
	Vaginal Candidiasis	Fluconazole 150mg PO stat