Differential Diagnosis for Recurrent BV, New Labial Cyst with Scant Clear Drainage and Painful
- Single most likely diagnosis:
- Bartholin's cyst or abscess: This is the most likely diagnosis given the presentation of a new labial cyst with scant clear drainage and pain. The history of recurrent bacterial vaginosis (BV) may also be relevant, as it could indicate an increased susceptibility to infections in the genital area, including the Bartholin's glands.
- Other Likely diagnoses:
- Infected sebaceous cyst: This could present similarly to a Bartholin's cyst or abscess, especially if the cyst becomes infected, leading to pain and drainage.
- Folliculitis or furuncle: An infection of the hair follicles in the labial area could cause pain and possibly some drainage, although it might not typically present as a distinct cyst.
- Vulvar vestibulitis: This condition involves inflammation of the vulvar vestibule and can cause pain, especially with pressure or touch, but it might not directly explain the presence of a cyst.
- Do Not Miss diagnoses:
- Necrotizing fasciitis: Although rare, this is a life-threatening condition that requires immediate attention. It could present with severe pain, swelling, and possibly drainage, but the key distinguishing feature is the rapid progression and severity of symptoms.
- Malignancy (e.g., vulvar cancer): While less common, any new, persistent, or changing lesion in the genital area should prompt consideration of malignancy, especially in older individuals or those with risk factors.
- Rare diagnoses:
- Hidradenitis suppurativa: This chronic skin condition can cause painful, inflamed lesions in areas of the body with apocrine glands, including the genital area, but it typically involves multiple lesions and a longer history of symptoms.
- Tuberculosis or other granulomatous infections: These could potentially cause cystic lesions or abscesses in the genital area, although they would be uncommon and might be associated with systemic symptoms or a relevant exposure history.
- Crohn's disease or other inflammatory bowel diseases with perianal or genital involvement: These conditions can cause a variety of lesions and fistulas in the genital and perianal areas, but they would typically be associated with gastrointestinal symptoms.