Bacterial Vaginosis (BV): This is often the most common cause of vaginal discharge in women of reproductive age. Symptoms include a fishy-smelling discharge, pruritis, and irritation, which align with the patient's presentation.

Vulvovaginal Candidiasis (VVC): Commonly known as a yeast infection, VVC is characterized by a thick, white, cottage cheese-like discharge, intense pruritis, and irritation. It's a frequent cause of vaginal symptoms in women.
Trichomoniasis: A sexually transmitted infection caused by the parasite Trichomonas vaginalis, leading to a frothy, greenish-yellow vaginal discharge, pruritis, and irritation.
Chlamydia and Gonorrhea: These sexually transmitted infections can cause vaginal discharge, though they are more commonly associated with other symptoms like dysuria and pelvic pain.

Pelvic Inflammatory Disease (PID): Although PID often presents with more severe symptoms like pelvic pain and fever, mild cases can manifest with vaginal discharge and pruritis. Missing PID can lead to serious complications like infertility and chronic pelvic pain.
Cervical Cancer: While less common in young women, cervical cancer can cause abnormal vaginal discharge. It's crucial to not miss this diagnosis due to its severe implications.
Desquamative Inflammatory Vaginitis (DIV): A condition characterized by a purulent vaginal discharge and significant inflammation. It can be mistaken for other infections but requires specific treatment.

Vaginal Tuberculosis: A rare condition in many parts of the world, vaginal tuberculosis can cause chronic vaginal discharge, among other symptoms.
Foreign Body: The presence of a foreign body in the vagina, especially in children but occasionally in adults, can lead to a malodorous discharge and irritation.
Lichen Sclerosus or Lichen Planus: These are rare skin conditions that can affect the vulva, causing pruritis and irritation, and potentially leading to architectural changes if left untreated.