Vaginal Discharge Solution
Vaginitis and vaginal discharge are common complaints prompting women to visit their health care providers. The differential diagnosis is extensive and should include physiologic discharge, chemical or irritant vaginitis, atrophic vaginitis, and vaginitis due to the infectious agents discussed in the following sections. Many over-the-counter products, such as topical antifungals, are widely available and allow women to self treat, often inappropriately. This makes diagnosis even more difficult and confusing when patients present with partially treated disease. Signs and symptoms of bacterial vaginosis (BV) include a foul smelling, homogeneous, white, adherent vaginal discharge. Vulvovaginal pruritis, burning, and dys-parenuria may be associated (52). Diagnosis is usually based on clinical criteria which generally include any three of the following (1) homogeneous, uniformly adherent discharge with little evidence of inflammation on examination (2) vaginal fluid pH 4.5 (3) amine fishy...
Fistulae typically present with benign symptoms and severe incontinence and excoriation are rare. Instead, these patients complain of intermittent vaginal discharge or the passage of gas through the vagina 76 . The diagnosis of these fistulae may be difficult. The best test can be done during rectoscopy by injecting air into the rectum and verifying its passage into the vagina. In some cases, examination should be done under anaesthesia. The treatment options in these cases are reduced, in our point of view, to the advancing flap technique described previously.
The presence of a vaginal discharge requires to be assessed and note made of its colour, consistency and smell for example, particularly strong odour may indicate anaerobic bacterial infection. Vaginal bleeding occurring after intercourse is usually caused by local pathology, e.g. cervical erosions, polyps or carcinoma. The presence of a vaginal discharge or intermenstrual, postcoital or postmenopausal bleeding, is an indication for a gynaecological assessment and examination.
Be responsible for dyspareunia and chronic infections secondary to retained secretions 161, 162 . These problems are less frequent after restorative proctocolectomy, where the presence of the ileal-pouch contributes towards maintaining the vagina in its normal position 163 . This has been confirmed in a survey that compared sexual function in women after restorative proctocolectomies or after procto-colectomy and Kock pouch the incidence of dys-pareunia was 18 and 38 respectively and none of the patients in the first group complained of vaginal discharge, compared to 18 of the second group 131 .
The diagnosis of PID is imprecise and should be considered in any woman with pelvic pain. Definitive diagnosis can be made by culture of involved areas, but this frequently involves invasive procedures such as culdocentesis, endometrial biopsy, and or laparoscopy. The differential diagnosis is extensive, and should include ectopic pregnancy, ovarian torsion, flare of endometriosis, ruptured ovarian cyst, appendicitis, cholecystitis, colitis, gastroenteritis, pyelonephritis, nephrolithiasis, and bowel perforation. The CDC recommends initiating antibiotic therapy for PID in patients with adnexal, lower abdominal or cervical motion tenderness (2). The presence of fever, an elevated erythrocyte sedimentation rate (ESR), and or C-reactive protein (CRP), and cervical or vaginal discharge with proven chlamydial or gonorrheal infection support the diagnosis of PID (2). The findings of hydrosalpinx, pyosalpinx with thickened tubular walls with or without free fluid in the pelvis, or...
Information gathered before the administration of the first dose establishes a database for comparison during therapy. In performing the preadministration assessment before giving the first dose of an antifungal drug, the nurse assesses the patient for signs of the infection. The nurse inspects for superficial fungal infections of the skin or skin structures (eg, hair, nails) and describes them on the patient's record. The nurse carefully documents any skin lesions, such as rough itchy patches, cracks between the toes, and sore and reddened areas, to obtain an accurate database. It also is important to describe any vaginal discharge or white plaques or sore areas of the mucous membranes. The nurse takes and records vital signs. The nurse weighs the patient scheduled to receive amphotericin or flucytosine because the dosage of the drug is determined according to the patient's weight.
Fungal superinfections commonly occur in the vagina, mouth, and anal and genital areas. Symptoms include lesions of the mouth or tongue, vaginal discharge, and anal or vaginal itching. Pseudomembranous colitis is a common bacterial superinfection candidi-asis or moniliasis is a common type of fungal superinfection.