Differential Diagnosis for Yellow Vaginal Discharge

• Single Most Likely Diagnosis
  • Bacterial Vaginosis (BV): This is the most common cause of vaginal discharge, characterized by a fishy odor and a thin, yellowish or grayish discharge. The high prevalence of BV in women of reproductive age makes it the most likely diagnosis.
• Other Likely Diagnoses
  • Trichomoniasis: A sexually transmitted infection caused by the parasite Trichomonas vaginalis, leading to a greenish-yellow, frothy discharge.
  • Gonorrhea: A sexually transmitted infection caused by Neisseria gonorrhoeae, which can cause a yellowish or greenish discharge.
  • Chlamydia: Another sexually transmitted infection that can cause a yellowish discharge, often accompanied by other symptoms like abdominal pain and dysuria.
• Do Not Miss Diagnoses
  • Pelvic Inflammatory Disease (PID): A serious condition that can result from untreated sexually transmitted infections, leading to severe consequences like infertility and chronic pelvic pain if not promptly treated.
  • Cervical Cancer: Although less common, cervical cancer can cause abnormal vaginal discharge, including yellow discharge, making it crucial not to miss this diagnosis.
• Rare Diagnoses
  • Foreign Body: The presence of a foreign body in the vagina, such as a forgotten tampon, can cause a foul-smelling, yellowish discharge.
  • Vulvovaginal Candidiasis (complicated): While typically causing a white, cottage cheese-like discharge, complicated cases or those involving non-albicans Candida species might present with a yellowish tint.
  • Desquamative Inflammatory Vaginitis (DIV): A rare condition characterized by a purulent, yellowish discharge and significant vaginal inflammation.