5 DNA-based diagnostic tools with varying degrees of sensitivity and specificity also are available. A reasonable alternative is to use a wet-mount and KOH preparation or Gram stain of the vagina in conjunction with the findings of the physical examination, and to reserve culture for cases of treatment failure. Culture of the vagina is costly, but may be the only way to ensure diagnosis of vulvovaginal candidiasis in equivocal cases. A recent analysis 3 found that examination of wet-mount preparations is neither highly sensitive nor specific for vulvovaginal candidiasis. Bacterial vaginosis often is identified based on the vaginal pH and the presence of clue cells on light microscopy (two of the Amsel criteria 4). Treatment with topical estrogen is effective.Īlthough it is tempting to treat vaginal complaints empirically based on the patient’s history alone, studies 2, 3 have demonstrated poor correlation between symptoms and the final diagnosis. Atrophic vaginitis results from estrogen deficiency. The standard treatment for trichomoniasis is a single 2-g oral dose of metronidazole. Culture and DNA probe testing are useful in diagnosing the infection examinations of wet-mount preparations have a high false-negative rate. Trichomoniasis may cause a foul-smelling, frothy discharge and, in most affected women, vaginal inflammatory changes. Topical azole and oral fluconazole are equally efficacious in the management of uncomplicated vulvovaginal candidiasis, but a more extensive regimen may be required for complicated infections. Cultures are helpful in women with recurrent or complicated vulvovaginal candidiasis, because species other than Candida albicans (e.g., Candida glabrata, Candida tropicalis) may be present. Diagnosis should rely on microscopic examination of a sample from the lateral vaginal wall (10 to 20 percent potassium hydroxide preparation). Vulvovaginal candidiasis can be difficult to diagnose because characteristic signs and symptoms (thick, white discharge, dysuria, vulvovaginal pruritus and swelling) are not specific for the infection. The standard treatment is oral metronidazole in a dosage of 500 mg twice daily for seven days. The diagnosis is based primarily on the Amsel criteria (milky discharge, pH greater than 4.5, positive whiff test, clue cells in a wet-mount preparation). Bacterial vaginosis is caused by proliferation of Gardnerella vaginalis, Mycoplasma hominis, and anaerobes. Vaginitis also can occur because of atrophic changes. These trusted information partners have more on this topic.Common infectious forms of vaginitis include bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. brand-name medicinesīack to top back to top Need more information? Can I take Nilstat Cream Pessary in sport? Find out on the Sport Integrity Australia.Other medicines containing the same active ingredients: nystatin.Please refer to our terms and conditions. This information is not intended to substitute medical advice, diagnosis or treatment and should not be exclusively relied on to manage or diagnose a medical condition. Reasonable care has been taken to provide accurate information at the time of creation. If you are suffering an acute illness, overdose, or emergency condition, call triple zero (000) and ask for an ambulance. Healthdirect medicines information is not intended for use in an emergency. Australian Register of Therapeutic Goods (ARTG)įor more information, see Medicine Information sources Disclaimer.You can report side effects to your doctor, or directly at Data sources You can help ensure medicines are safe by reporting the side effects you experience. During pregnancy, you should discuss your medicine use with your doctor or pharmacist. This medicine is generally considered safe during pregnancy if taken as directed. open tool tip to find out more Pregnant or planning a pregnancy? This medicine is available from a pharmacy without prescription. You can read more about the scheduling of medicines as well as the different scheduling categories on our Scheduling of medicines and poisons information page. Medicines with a low safety risk are usually less tightly controlled than medicines with a higher safety risk. What is the medicines and poisons schedule?Īll medicines and poisons in Australia are categorised by how they are made available to the public.
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