Verified

Under Review

7/29/21, 4:09 PM

Rosie Quinn

A 15 year old female patient presents to her primary care for concerns about vaginal discharge. She states that she has recently noticed significant vaginal itching that she finds embarrassing and distracting during the school day. She describes the discharge as white and clumpy but hasn't noticed any associated odor. She has a history of asthma and recently completed a course of steroids due to an illness-related exacerbation of her symptoms. Which of the following is the most likely diagnosis?

Gardnerella vaginalis

Chlamydia trachomatis

Physiologic discharge

Vulvovaginal candidiasis

Correct Answer:

D

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.