Summary
定义
病史和体格检查
关键诊断因素
- vaginal discharge
- dysuria
- discharge adherent to vaginal mucosa
其他诊断因素
- prior episodes
- pruritus
- vulvodynia
- vaginal dryness
- dyspareunia
- erythema
- pale epithelium
- shiny epithelium
- decreased elasticity
- friable epithelium
- fever
- vaginal bleeding
- abdominal pain
- strawberry cervix
危险因素
- douching
- poor or excessive hygiene
- antibiotic use
- change in feminine hygiene products and/or soap
- HIV infection
- diabetes
- black women
- intrauterine device
- oral contraceptive pill use
- latex condom/diaphragm
- reproductive age
- menopause
- multiple or new sex partners
- tobacco
- increased frequency of intercourse
- pregnancy
诊断性检查
首要检查
- vaginal pH
- amine "whiff" test of vaginal secretions
- wet mount microscopy of vaginal secretions
- Gram stain of vaginal secretions
- HIV test
- nucleic acid amplification test (NAAT)
- venereal disease research laboratory (VDRL) test
- serum rapid plasma reagin (RPR) test
需考虑的检查
- culture of vaginal secretions
- polymerase chain reaction (PCR) for trichomoniasis on vaginal secretions
- rapid enzyme tests of vaginal secretions
治疗流程
nonpregnant: isolated acute episode
pregnant: isolated acute episode
atrophic vaginitis
irritant or allergic vaginitis
nonpregnant: persistent or recurrent symptoms
pregnant: persistent or recurrent symptoms
撰稿人
作者
Diego Illanes, MD, FACOG, FACS
Medical Director
Urogynecology
Milford Regional
Milford
MA
利益声明
DSI is an advisor for Coloplast, Medtronic and Vicarious.
同行评议者
David Chelmow, MD
Chair
Department of Obstetrics and Gynecology
Virginia Commonwealth University
Richmond
VA
利益声明
DC declares that he has no competing interests.
Jonathon Solnik, MD
Director
Minimally Invasive Gynecologic Surgery
Cedars-Sinai Medical Center
Los Angeles
CA
利益声明
JS declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.全文 摘要
American College of Obstetricians and Gynecologists. Vaginitis in nonpregnant patients: ACOG practice bulletin, number 215. Obstet Gynecol. 2020 Jan;135(1):e1-e17. 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Gonorrhea
- Chlamydia
- Cervicitis
更多 鉴别诊断指南
- UK national guideline on the management of Trichomonas vaginalis
- UK national guideline on the management of Trichomonas vaginalis
更多 指南患者教育信息
Bacterial vaginosis
Menopause: should I take HRT?
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