Vaginitis

Signs and symptoms Symptoms may include: Change in color, odor or amount of discharge from your vagina Vaginal itching or irritation Pain during intercourse Painful urination Light vaginal bleeding

1. 無色透明有惡臭的白帶：分泌量增多， 常見於子宮頸糜爛、卵巢功能失調主要 是停經後雌激素缺乏所致．陰道逐漸萎 縮、變薄、乳酸桿菌減少，或雌激素等 葯物造成

乳白色渣狀白帶：是念珠菌感染即黴菌性陰道 炎所特有的一種白帶，常有外陰瘙癢或灼痛感。 3. 膿性白帶：由化膿性細菌感染所引起，多見 老年性陰道炎、陰道內異物、慢性子宮頸炎、 子宮內膜炎和子宮積膿的病人。若陰道分泌物 呈黃色、膿樣兼有泡沫，且若有外陰瘙癢時， 應考慮為「滴蟲性陰道炎」

This infection can cause a foul-smelling discharge, which may be frothy, green-yellow, and profuse or thin, white, and scant. Other findings include pruritus; an inflamed, erythematous vagina with tiny petechiae; dysuria and urinary frequency; dyspareunia; postcoital spotting; and menorrhagia or dysmenorrhea. About 70% of patients are asymptomatic.

This infection, caused by Gardnerella vaginalis (formerly called Haemophilus vaginalis), results from an ecozogic disturbance of the vaginal flora. It produces a thin, foul-smelling, green or gray-white discharge that adheres to the vaginal walls and can be easily wiped away, leaving healthy-looking tissue. Pruritus, redness, and other mild signs of vaginal irritation may also occur

Infection with Candida albicans causes a profuse, white, curdlike discharge with a yeasty, sweet odor. Onset is abrupt, usually just before menses or during a course of antibiotics. Exudate may be lightly attached to the labia and vaginal walls and is commonly accompanied by vulvar redness and edema. The inner thighs may be covered with a fine red dermatitis and weeping erosions. Intense labial itching and burning may also occur. Some patients experience external dysuria

I. Predisposing Factors A. Diabetes Mellitus B. Medications 1. Corticosteroid 2. Immunosuppressant Medications 3. Broad spectrum antibiotics 4. Oral Contraceptive a.Increases frequency of Candida carrier state b.Does not increase symptomatic vulvovaginitis

C.Heat and moisture retaining clothing (e.g. nylon) D.Pregnancy E.Premenstrual phase of the Menstrual Cycle F.Depressed cell mediated immunity (e.g. AIDS) G.Obesity

含血性白帶：性接觸時出血，不要排除 惡性腫瘤的可能性，可能有重度子宮頸 糜爛、慢性子宮頸炎、子宮頸息肉、子 宮頸癌等，提高警覺。 5. 水樣白帶：往往是由於病變組織壞死 或變性所引起，如子宮黏膜下肌瘤脫出 到陰道內。

Partner Treatment Partners of patients with an STD are likely to be infected themselves and should be offered treatment. Partner notification and referral can be one of the most important ways to detect and treat asymptomatic patients

Confidentiality, a nonjudgmental attitude and the absence of coercion are important for the success of partner notification. WHO recommends that epidemiological treatment (treatment based solely on the diagnosis of the index patient without any laboratory investigation) be given to all partners

A 21-year-old women complains of vaginal discharge that she states has a fishy odor. It is particularly noticeable following coitus. You examine her and find the pH is 5. The most likely diagnosis is A. Candida albicans B. Bacterial vaginosis C. Trichomonas vaginalis D. Normal postcoital discharge