Correct answer: D

This description of clumpy, white discharge that is significantly different than the patient's usual vaginal discharge and associated with vulvar itching is suspicious for vulvovaginal candidiasis (answer D). The appearance and lack of odor of the discharge makes a diagnosis of Garnerella vaginalis, or bacterial vaginosis, less likely (answer A). Chlamydia trachomatis is an unlikely, though not impossible, diagnosis in a patient who denies sexual activity (answer B). Finally, the acute change that this patient describes in her discharge makes it unlikely that her presentation is due to physiologic discharge (answer C).

Source:

Mitchell, Helen. "Vaginal Discharge - Causes, Diagnosis, and Treatment." BMJ 328.7451 (2004): 1306-1308. Web.

Rosie Quinn

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