Differential Diagnosis for Yellow Vaginal Discharge
- Single Most Likely Diagnosis + Bacterial Vaginosis (BV): This is often the most common cause of abnormal vaginal discharge, characterized by a fishy odor and a thin, yellowish or grayish discharge. The justification for this being the single most likely diagnosis is based on its high prevalence among women of reproductive age and the typical presentation of symptoms.
- Other Likely Diagnoses + Trichomoniasis: Caused by the protozoan parasite Trichomonas vaginalis, this infection can lead to a yellow-green, frothy vaginal discharge. It's a common sexually transmitted infection (STI) and should be considered in sexually active women. + Yeast Infection (Candidiasis): Although typically associated with a white, cottage cheese-like discharge, some cases can present with a yellowish tint, especially if there's a mixed infection. It's a common cause of vaginal discharge and should be considered, especially in women with risk factors like antibiotic use or diabetes. + Chlamydia and Gonorrhea: These STIs can cause an abnormal vaginal discharge, which may appear yellow or cloudy. They are significant considerations in sexually active women, especially those with new or multiple partners.
- Do Not Miss Diagnoses + Pelvic Inflammatory Disease (PID): While PID may not always present with a distinct yellow discharge, it can cause abnormal discharge and is a critical diagnosis not to miss due to its potential for severe complications, including infertility and chronic pelvic pain. It often results from untreated STIs like chlamydia and gonorrhea. + Cervical Cancer: Abnormal vaginal discharge can be a symptom of cervical cancer, although it's a less common presentation. Given the potential severity of this diagnosis, it's crucial to consider it, especially in women with risk factors like HPV infection or those who are overdue for a Pap smear.
- Rare Diagnoses + Foreign Body: A retained foreign body in the vagina, such as a forgotten tampon, can cause a foul-smelling, yellowish discharge. This is more common in young girls or women who use tampons. + Desquamative Inflammatory Vaginitis (DIV): A rare condition characterized by a purulent, yellowish discharge and significant vaginal inflammation. It's a diagnosis of exclusion and should be considered when other causes have been ruled out. + Vaginal Cancer: Similar to cervical cancer, vaginal cancer can present with abnormal vaginal discharge, although it's much rarer. It's essential to consider in the differential diagnosis due to its severity, especially in postmenopausal women or those with risk factors like HPV infection.