Vaginal infection

Sexually transmitted diseases

Chlamydia

Chlamydia trachomatis is a small bacterium, and is the most common STD in the developed world! Around 5-10% of 20-30 year olds have it! There can be some inflammation or discharge, but often it is asymptomatic. The big problems is it can cause pelvic inflammatory disease, which can lead to infertility. Treatment is with a tetracycline, erythromycin or azithromycin.

Gonorrhoea

This time its Neisseria gonorrhoeae, rearing its ugly head. It's particularily prevalent in the developing world. Again, its usually asymptomatic, but can cause some irritation and discharge. Again it causes PID, which you don't want. Often resistant to penicillin, in which case, use ciprofloxacin.

Genital warts

These are caused by human papilloma virus, and again, are extremely common. The warts are usually multiple, and found on the vulva, in the vagina and on the cervix, where they can lead to cervical intraepithelial neoplasia. Interestingly though, the types of HPV that cause cervical cancer generally aren't the same as the wart ones. So having genital warts may not actually mean your chance of getting cancer gets any higher.

Genital herpes

Multiple small vesicles and ulcers around the entrance of the vagina, or on the penis. There can also be dysuria and local lymphadenopathy. In about 75% of cases, after the first episode, it recurs. Herpes simplex type 2 is the usual cause of herpes, although it sometimes can be type 1. Acyclovir is a treatment that reduces symptoms. Neonatal herpes has a high mortality and can be prevented.

Other infections

Candidiasis

This is the commonest cause of vaginal infections. It's found in 20% of women! Being pregnant, having diabetes, and use of antibiotics are risk factors. Often there are no symptoms, but if there are you get a "cottage cheese" discharge, with pruritis. Treatment with topical imidazoles and oral fluconazole does the trick! More common in immuno-compomised, so be aware.

Bacterial vaginosis

This is when the normal bacteria in the vagina are overgrown by particular bugs. No one knows why it happens, but it still happens in about 12% of women. No itchyness, but a fishy smell, sometimes with a discharge. Best treatment with metronidazole. Can be a symptom of underlying PID.

Foreign bodies

In children, a common cause of vaginal discharge is foreign bodies. In adults, you can get toxic shock syndrome from a retained tampon! This can lead to a toxic Staphlococcus aureus infection. Quite bad!