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Cytolytic Vaginosis


Step 1: View clinicals

A 30 year old woman presents with a thick whitish vaginal discharge for 3 months, in association with vulvovaginal itching. She also experiences pain during intercourse. The symptoms tended to increase in severity around two weeks prior to menstruation. Her menstrual cycles are regular, being around 28 days in length. Her medical and gynecological histories are unremarkable, while she is not on any drugs. She is in a monogamous relationship.

Step 2: Order all relevant investigations

Wet Mount Microscopy

Microscopy reveals the presence of a large number of intermediate epithelial cells, copious amounts of lactobacilli of varying lengths, and cytoplasmic debris (including bare and naked nuclei). No leukocytes are seen.

Vaginal pH

The vaginal pH is 3.8

Whiff Test

The whiff test is negative.

Pap Smear

The pap smear is within normal limits.

Step 3: Select appropriate management

Topical Antimycotics
Screen Partner
NaHCO3 Douching
Stop using Tampons

Score: ★★☆