Differential Diagnosis for Vaginal Burning in a 19-year-old Female

Single Most Likely Diagnosis

• Vulvovaginal Candidiasis (Yeast Infection): This is a common condition in young women, often presenting with vaginal burning, itching, and abnormal discharge. The symptoms and demographic information make this a highly probable diagnosis.

Other Likely Diagnoses

• Bacterial Vaginosis (BV): Characterized by an imbalance in vaginal flora, leading to symptoms like vaginal burning, itching, and a fishy odor. It's a common condition in sexually active women.
• Trichomoniasis: A sexually transmitted infection that can cause vaginal burning, itching, and a foul-smelling discharge.
• Vaginal Atrophy: Although more common in postmenopausal women, vaginal atrophy can occur in younger women, especially those on certain medications or with hormonal imbalances, leading to vaginal dryness and burning.
• Contact Dermatitis: An allergic reaction or irritation from soaps, douches, or other products can cause vaginal burning and itching.

Do Not Miss Diagnoses

• Herpes Simplex Virus (HSV): A sexually transmitted infection that can cause severe vaginal burning, especially during outbreaks. Missing this diagnosis could lead to complications like increased risk of HIV transmission and neonatal herpes.
• Gonorrhea and Chlamydia: These sexually transmitted infections can cause vaginal burning and, if untreated, can lead to serious complications like pelvic inflammatory disease (PID) and infertility.
• Syphilis: Another sexually transmitted infection with a wide range of symptoms, including vaginal burning in its early stages. Untreated syphilis can lead to severe health issues, including neurological problems and birth defects.

Rare Diagnoses

• Lichen Sclerosus: A rare condition that creates patchy, white skin in the genital area and can cause itching, burning, and pain.
• Vulvar Intraepithelial Neoplasia (VIN): Abnormal cell growth on the vulva that can cause burning, itching, and pain. It's a precursor to vulvar cancer.
• Desquamative Inflammatory Vaginitis (DIV): A rare condition characterized by vaginal burning, itching, and a purulent discharge, often resistant to standard treatments.

Each of these diagnoses should be considered based on the patient's symptoms, sexual history, and other risk factors. A thorough examination, laboratory tests, and sometimes a biopsy may be necessary to confirm the diagnosis.