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 common in women of reproductive age and 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 can cause a greenish, frothy discharge with a strong odor, along with itching and irritation.
- Chlamydia: A sexually transmitted infection caused by Chlamydia trachomatis. It can cause a mucopurulent discharge, along with symptoms like dysuria and pelvic pain.
Do Not Miss Diagnoses
- Gonorrhea: Another sexually transmitted infection, caused by Neisseria gonorrhoeae. It can cause a purulent discharge and is a significant concern due to the risk of complications like pelvic inflammatory disease (PID) and infertility if left untreated.
- Pelvic Inflammatory Disease (PID): An infection of the upper genital tract that can be caused by various bacteria, including those that cause sexually transmitted infections. PID can present with a variety of symptoms, including abnormal vaginal discharge, and is a medical emergency due to the risk of long-term complications like infertility and chronic pelvic pain.
- Cervical Cancer: Although less common, abnormal vaginal discharge can be a symptom of cervical cancer. Regular screening is crucial for early detection.
Rare Diagnoses
- Desquamative Inflammatory Vaginitis (DIV): A rare condition characterized by a purulent discharge and significant inflammation of the vaginal walls. The exact cause is unknown, but it is thought to be related to an autoimmune response.
- Foreign Body: The presence of a foreign body in the vagina, such as a retained tampon, can cause a foul-smelling discharge. This condition is more common in young girls or women who use tampons.
- Vaginal Tuberculosis: A rare condition in many parts of the world, vaginal tuberculosis can cause a variety of symptoms, including abnormal vaginal discharge. It is more common in areas where tuberculosis is endemic.