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Common Causes of Vaginitis

To identify the key insights or developments described in this article
1 Credit CME

Vaginitis is defined as infection or inflammation of the vagina. More than 70% of cases of vaginitis are attributed to vulvovaginal candidiasis (VVC), bacterial vaginosis (BV), or trichomoniasis.1 Symptoms include abnormal discharge, malodor, vulvovaginal pruritus, irritation, and dyspareunia. Some individuals with VVC present primarily with vulvar pruritus without vaginal discharge. However, none of these symptoms correlate well with specific diagnoses.2 Self-diagnosis, medical history, or both are insufficient for accurate diagnosis, and it is recommended that diagnostic testing be performed.1

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Article Information

Accepted for Publication: April 4, 2022.

Corresponding Author: Catherine Leclair, MD, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, UHN 50, Portland, OR 97239 (leclairc@ohsu.edu).

Conflict of Interest Disclosures: None reported.

References
1.
Workowski  KA , Bachmann  LH , Chan  PA ,  et al.  Sexually transmitted infections treatment guidelines, 2021.   MMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1 PubMedGoogle ScholarCrossref
2.
Mills  BB .  Vaginitis: beyond the basics.   Obstet Gynecol Clin North Am. 2017;44(2):159-177.PubMedGoogle ScholarCrossref
3.
Gaydos  CA , Beqaj  S , Schwebke  JR ,  et al.  Clinical validation of a test for the diagnosis of vaginitis.   Obstet Gynecol. 2017;130(1):181-189.PubMedGoogle ScholarCrossref
4.
Cartwright  CP , Lembke  BD , Ramachandran  K ,  et al.  Comparison of nucleic acid amplification assays with BD affirm VPIII for diagnosis of vaginitis in symptomatic women.   J Clin Microbiol. 2013;51(11):3694-3699. doi:10.1128/JCM.01537-13 PubMedGoogle ScholarCrossref
5.
Denison  HJ , Worswick  J , Bond  CM ,  et al.  Oral versus intra-vaginal imidazole and triazole anti-fungal treatment of uncomplicated vulvovaginal candidiasis (thrush).   Cochrane Database Syst Rev. 2020;8(8):CD002845.PubMedGoogle Scholar
6.
Neal  CM , Kus  LH , Eckert  LO , Peipert  JF .  Noncandidal vaginitis.   Am J Obstet Gynecol. 2020;222(2):114-122.PubMedGoogle ScholarCrossref
7.
Li  C , Wang  T , Li  Y ,  et al.  Probiotics for the treatment of women with bacterial vaginosis.   Eur J Pharmacol. 2019;864:172660.PubMedGoogle Scholar
8.
Kissinger  P , Muzny  CA , Mena  LA ,  et al.  Single-dose versus 7-day-dose metronidazole for the treatment of trichomoniasis in women.   Lancet Infect Dis. 2018;18(11):1251-1259.PubMedGoogle ScholarCrossref
9.
Crandall  CJ .  Treatment of vulvovaginal atrophy.   JAMA. 2019;322(19):1910-1911.PubMedGoogle ScholarCrossref
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Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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