Differential Diagnosis for Foul Vaginal Discharge
Single Most Likely Diagnosis
- Bacterial Vaginosis (BV): This is the most common cause of foul vaginal discharge. It is characterized by an imbalance in the normal vaginal flora, with a decrease in lactobacilli and an increase in anaerobic bacteria, leading to a fishy-smelling discharge.
Other Likely Diagnoses
- Trichomoniasis: A sexually transmitted infection caused by the parasite Trichomonas vaginalis, which can cause a foul-smelling, greenish-yellow vaginal discharge.
- Vaginal Candidiasis: A fungal infection caused by Candida species, which can cause a thick, white, cottage cheese-like discharge with a sour smell.
- Chlamydia and Gonorrhea: Sexually transmitted infections that can cause a foul-smelling vaginal discharge, although this is not their most common symptom.
Do Not Miss Diagnoses
- Pelvic Inflammatory Disease (PID): A serious infection of the female reproductive organs that can cause a foul-smelling vaginal discharge, along with other symptoms like pelvic pain and fever. If missed, PID can lead to infertility and other complications.
- Cervical Cancer: Although rare, cervical cancer can cause a foul-smelling vaginal discharge. It is essential to not miss this diagnosis, as early detection and treatment can significantly improve outcomes.
Rare Diagnoses
- Foreign Body: A rare cause of foul vaginal discharge, often seen in children or individuals who have inserted a foreign object into the vagina.
- Desquamative Inflammatory Vaginitis (DIV): A rare condition characterized by a severe inflammatory response in the vagina, leading to a foul-smelling discharge.
- Vaginal Cancer: A rare type of cancer that can cause a foul-smelling vaginal discharge, along with other symptoms like vaginal bleeding and pelvic pain.