Leucorrhea

• vaginitis is diagnosis given to women who

complain of abnormal vaginal discharge with
vulvar burning, irritation, or itching
• leading causes of vaginal discharge are :
– bacterial vaginosis,
– candidiasis,
– trichomoniasis
Hoffman, Schorge, Schaffer, Halvorson. William’s Gynecology. 2nd Ed. New York: McGraw-Hill Education, 2012
Bacterial Vaginosis (BV)
• Associated with a • Symptoms:
significant /absence of – nonirritating, malodorous
normal hydrogen peroxide- vaginal discharge (but may
producing Lactobacillus not always be present)
speciesovergrowth of – vagina isn’t erythematous,
anaerobic species: – cervical examination reveals
no abnormalities.
– Gardnerella vaginalis,
– Ureaplasma urealyticum,
– Mobiluncus species,
– Mycoplasma hominis,
– Prevotella species.

Hoffman, Schorge, Schaffer, Halvorson. William’s Gynecology. 2nd Ed. New York: McGraw-Hill Education, 2012
Hoffman, Schorge, Schaffer, Halvorson. William’s Gynecology. 2nd Ed. New York: McGraw-Hill Education, 2012
 Candidiasis
• commonly caused by
Candida albicans, which can
be found in the vaginas of
asymptomatic patients
• commonly in:
– warmer climates
– obese patients,
– immunosuppression,
– diabetes mellitus,
– pregnancy,
– broad-spectrum antibiotic
use predispose women to
clinical infection.

Hoffman, Schorge, Schaffer, Halvorson. William’s Gynecology. 2nd Ed. New York: McGraw-Hill Education, 2012
 Candidiasis

Hoffman, Schorge, Schaffer, Halvorson. William’s Gynecology. 2nd Ed. New York: McGraw-Hill Education, 2012
 Candidiasis

Hoffman, Schorge, Schaffer, Halvorson. William’s Gynecology. 2nd Ed. New York: McGraw-Hill Education, 2012
 Trichomoniasis
• incidence appears to  with
patient age
• more commonly diagnosed in
♀because most ♂ are
asymptomatic.
• co-infection with other sexually
transmitted pathogens is common
(N gonorrhoeae)
• Vertical transmission during birth
is possible
• Adverse effects of metronidazole:
metallic taste & disulfiram-like
reaction (nausea and vomiting) if
combined with alcohol.
– should abstain from alcohol during
use and for 24 hours following herapy
& for 72 hours after tinidazole
Hoffman, Schorge, Schaffer, Halvorson. William’s Gynecology. 2nd Ed. New York: McGraw-Hill Education, 2012
Hoffman, Schorge, Schaffer, Halvorson. William’s Gynecology. 2nd Ed. New York: McGraw-Hill Education, 2012