Symptom Finder - Vaginal Discharge
Vaginal Discharge
The physician should have no problem in differentiating the discharge of candidiasis from trichomonas because of the cheesy white appearance of the former compared with the frothy yellow appearance of the latter. He or she can do a wet saline “prep” and potassium hydroxide (KOH) “prep” as a further means of differentiating the two. One can use a Gram stain to diagnose gonorrhea or bacterial vaginitis, but culture and diagnosis by exclusion are the usual means of diagnosis. More recently, it has been possible to diagnose gonorrhea and chlamydia by sending a sample of urine to the laboratory.
One should be sure to check for infection of the Skene and Bartholin glands. Also, remember that a clear or milky white discharge is often due
to chronic cervicitis, which is obvious if one uses a strong light to examine the cervix. The best way to do that is with a fiberoptic vaginoscope.
Not infrequently, a urethral discharge is the cause of the “vaginal” discharge, so be sure to milk the urethra. If the cervix is soft to palpation,
the discharge may be due to pregnancy. Finally, a brownish discharge may be due to a rectovaginal fistula due to carcinoma or Crohn disease. Of
course, this is a rare condition today.
The physician should have no problem in differentiating the discharge of candidiasis from trichomonas because of the cheesy white appearance of the former compared with the frothy yellow appearance of the latter. He or she can do a wet saline “prep” and potassium hydroxide (KOH) “prep” as a further means of differentiating the two. One can use a Gram stain to diagnose gonorrhea or bacterial vaginitis, but culture and diagnosis by exclusion are the usual means of diagnosis. More recently, it has been possible to diagnose gonorrhea and chlamydia by sending a sample of urine to the laboratory.
One should be sure to check for infection of the Skene and Bartholin glands. Also, remember that a clear or milky white discharge is often due
to chronic cervicitis, which is obvious if one uses a strong light to examine the cervix. The best way to do that is with a fiberoptic vaginoscope.
Not infrequently, a urethral discharge is the cause of the “vaginal” discharge, so be sure to milk the urethra. If the cervix is soft to palpation,
the discharge may be due to pregnancy. Finally, a brownish discharge may be due to a rectovaginal fistula due to carcinoma or Crohn disease. Of
course, this is a rare condition today.