Recurrent Infectious Vaginitis: A Practical Approach for the Primary Care Clinician

Golsa M Yazdy; Caroline Mitchell; Jack D Sobel; Susan Tuddenham

doi:10.1016/j.mcna.2023.08.017

Recurrent Infectious Vaginitis: A Practical Approach for the Primary Care Clinician

Med Clin North Am. 2024 Mar;108(2):373-392. doi: 10.1016/j.mcna.2023.08.017. Epub 2023 Sep 14.

Authors

Golsa M Yazdy¹, Caroline Mitchell², Jack D Sobel³, Susan Tuddenham⁴

Affiliations

¹ Department of Gynecology & Obstetrics, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD 21224, USA.
² Department of Obstetrics and Gynecology, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
³ Department of Medicine, Division of Infectious Diseases, Wayne State University, 3901 Chrysler Drive Suite 4A, Detroit, MI 48201, USA.
⁴ Department of Medicine, Division of Infectious Diseases, Johns Hopkins University, 5200 Eastern Avenue, MFL Center Tower, Suite 381, Baltimore, MD 21224, USA. Electronic address: [email protected].

PMID: 38331486
DOI: 10.1016/j.mcna.2023.08.017

Abstract

Recurrent infectious vaginitis can lead to significant morbidity, patient frustration, and health care costs. The most common causes are bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC); however, other infectious and noninfectious etiologies should be considered in patients with recurrent symptoms. A detailed history and physical examination with appropriate testing at the time of symptoms is critical to establishing a correct diagnosis. Management options for recurrent BV and VVC are limited. Complex cases including those with atypical symptoms, negative testing for common causes, refractory symptoms despite appropriate therapy or recurrences during suppressive therapy will require referral to specialist care.

Keywords: Bacterial vaginosis; Recurrent bacterial vaginosis; Recurrent vaginitis; Recurrent vulvovaginal candidiasis; Vulvar symptoms; Vulvovaginal candidiasis.

Publication types

Review

MeSH terms

Candidiasis, Vulvovaginal* / diagnosis
Candidiasis, Vulvovaginal* / drug therapy
Female
Humans
Primary Health Care
Vaginosis, Bacterial* / diagnosis
Vaginosis, Bacterial* / drug therapy
Vaginosis, Bacterial* / microbiology