Abnormal Vaginal Discharge

Introduction

• Abnormal vaginal discharge is defined as discharge that differs from usual with respect to colour/odour/consistency (e.g., discolored or purulent or malodorous).
• Abnormal discharge is often associated with vulvar pruritis or pain with intercourse, or painful or difficult urination or lower abdominal pain.
• Routinely check for abnormal vaginal discharge in women presenting with these symptoms.
• Abnormal vaginal discharge may be sign of infection of the vagina and/or the cervix or salphingits.
• Abdominal and bimanual pelvic examinations should be performed routinely in all women presenting with vaginal discharge to rule out upper genital tract infection

Treatment of cervicitis (for both chlamydia and gonorrhea)

• Tab Azomax (Azithromycin) 1 g, 1 tab PO stat a single dose OR Cap Doxycyline (Vibramycin) 100mg 1 tab PO BD for 7 days
• Inj Ceftriaxone (Oxidil) 250mg IM Stat as a single dose or Tab Cefim (Cefixime) 400mg 1 Tab PO stat as a single dose.

Treatment for Bacterial Vaginosis and trichomoniasis

• Tab Fasigyn (Tinidazole) 500mg, 4 tablets PO as a single dose OR
• Tab Flagyl (Metronidazole) 400mg, 5 tabs PO stat as a single dose

Treatment of Vulvovaginal candidiasis

• Tab Clozox (Clotrimazole) 500mg (Vaginal tablet) 1 tab as a single dose, inserted deep into the vagina at bedtime
• If the patient has extensive Vulvar involvement, use Gyne Daktarin (Miconazole 2% vaginal cream) 2 applications to the vulva daily for 7 days.

Treatment of the partner

• When the patient is treated for vaginitis or cervicitis, the sexual partner receives the same treatment as the patient, whether or not symptoms are present.
• In the case of Vulvovaginal candidiasis, the partner is treated only if symptomatic (Itching and redness of the glans/prepuce).