Differential Diagnosis for Vaginal Discharge
Single Most Likely Diagnosis
- Bacterial Vaginosis (BV): This is the most common cause of vaginal discharge in women of reproductive age. It is characterized by an imbalance of the normal vaginal flora, with a decrease in lactobacilli and an increase in anaerobic bacteria. Symptoms include a thin, white, or gray discharge with a fishy odor.
Other Likely Diagnoses
- Vulvovaginal Candidiasis (VVC): Also known as a yeast infection, this condition is caused by an overgrowth of Candida species. It is characterized by a thick, white, cottage cheese-like discharge and intense itching.
- Trichomoniasis: A sexually transmitted infection caused by the parasite Trichomonas vaginalis. It is characterized by a greenish-yellow, frothy discharge with a strong odor.
- Chlamydia: A sexually transmitted infection caused by Chlamydia trachomatis. It can cause a mucopurulent discharge, but often presents with other symptoms such as dysuria and pelvic pain.
Do Not Miss Diagnoses
- Gonorrhea: A sexually transmitted infection caused by Neisseria gonorrhoeae. It can cause a purulent discharge and is often associated with other symptoms such as dysuria and pelvic pain. If left untreated, it can lead to serious complications such as pelvic inflammatory disease (PID) and infertility.
- Pelvic Inflammatory Disease (PID): An infection of the upper genital tract that can be caused by a variety of bacteria, including Neisseria gonorrhoeae and Chlamydia trachomatis. It is characterized by pelvic pain, fever, and a purulent discharge. If left untreated, it can lead to serious complications such as infertility and chronic pelvic pain.
- Cervical Cancer: Although rare, cervical cancer can cause a vaginal discharge, especially if it has invaded the vagina. It is essential to perform a Pap smear and/or HPV testing to rule out this diagnosis.
Rare Diagnoses
- Desquamative Inflammatory Vaginitis (DIV): A rare condition characterized by a purulent discharge and intense inflammation of the vagina.
- Foreign Body: A rare cause of vaginal discharge, often seen in children or women who have inserted a foreign object into the vagina.
- Vaginal Tumors: Rare tumors such as vaginal adenocarcinoma or sarcoma can cause a vaginal discharge.