Non-Sexually Transmitted Infections

Question 1

What are the causes of bacterial vaginosis?

Answer 1

Normal flora disturbed, reduced lactobacilli, less H peroxide prod, more alkali pH, more bacterial growth

MO = gardnerella vaginalis, anaerobes and mycoplasmas

Disturbance = sex, IUD, oral sex, STI, vaginal douching, Abx, smoking

Question 2

How does bacterial vaginosis present?

Answer 2

Asymptomatic

Offensive fishy smelling vaginal discharge - Not usually associated with soreness, itching or irritation

Thin, white/grey, homogenous vaginal discharge

Question 3

How should bacterial vaginosis be investigated?

Answer 3

High vaginal smear = clue cells, reduced lactobacilli, absence of pus cells

Vaginal pH >4.5

KOH whiff test - addition of alkali to vaginal discharge releases strong fishy odour

Question 4

Outline the management of bacterial vaginosis

Answer 4

Metronidazole 400mg BD 5d

Question 5

What are the risk factors for a candida infection

Answer 5

• preg
• DM
• Abx
• corticosteroids
• immunosupression

Question 6

How does an candida infection present?

Answer 6

Pruritus vulvae

Vaginal discharge - white, curd-like

Dysuria

Erythema and swelling of the vulva

Satellite lesions

Question 7

Outline the management of a candida infection

Answer 7

Clotrimazole 500mg pessary PV stat, clotrimazole 1% cream top BD for 2w