Differential Diagnosis for Female 23 yo with Increased Vaginal Discharge, Pruritis, and Irritation
- Single Most Likely Diagnosis
- Bacterial Vaginosis (BV): This is the most common cause of vaginal discharge in women of reproductive age. Symptoms such as increased vaginal discharge with a fishy odor, pruritis, and irritation are classic for BV. The diagnosis can be confirmed with a whiff test, pH testing, and microscopic examination of the discharge.
- Other Likely Diagnoses
- Vulvovaginal Candidiasis (VVC): Also known as a yeast infection, VVC is a common cause of vaginal discharge and pruritis. It typically presents with a thick, white, cottage cheese-like discharge and intense itching.
- Trichomoniasis: A sexually transmitted infection caused by the parasite Trichomonas vaginalis. It can cause an increase in vaginal discharge, which may be frothy, yellow-green, and have a foul odor, along with pruritis and irritation.
- Chlamydia and Gonorrhea: These sexually transmitted infections can cause an increase in vaginal discharge, though they more commonly present with symptoms like dysuria and abdominal pain.
- Do Not Miss Diagnoses
- Pelvic Inflammatory Disease (PID): While PID may not always present with vaginal discharge as a primary symptom, it is crucial to consider due to its potential for severe complications, including infertility and chronic pelvic pain. Symptoms can include lower abdominal pain, fever, and abnormal vaginal discharge.
- Cervical Cancer: Though rare in young women, any abnormal vaginal bleeding or discharge could potentially be a symptom of cervical cancer, especially if there is a history of untreated HPV infection.
- Rare Diagnoses
- Desquamative Inflammatory Vaginitis (DIV): A rare condition characterized by a purulent vaginal discharge and significant inflammation of the vaginal walls. It can cause severe pruritis and irritation.
- Vaginal Foreign Body: The presence of a foreign body in the vagina can cause an increase in discharge, pruritis, and irritation, though this is more common in younger girls.
- Allergic or Irritant Contact Dermatitis: This can occur due to sensitivity to soaps, douches, or other products used in the genital area, leading to irritation and discharge.