eMedicine Specialties > Emergency Medicine > Obstetrics & Gynecology
Vaginitis: Follow-up
Updated: Nov 3, 2009
Follow-up
Further Inpatient Care
- Parenteral treatment of infectious causes for vaginitis is rarely indicated. Complicated cases of certain infections (eg, gonorrhea, chlamydia) may require parenteral treatment.
Further Outpatient Care
- Recommend techniques of proper genital hygiene.
- Refer for sexual abuse evaluation all children in whom vaginitis was caused by an STD (see Pediatrics, Child Sexual Abuse).
- Treat sexual partners of patients with identified STDs.
Complications
- Infectious complications (eg, pelvic inflammatory disease, systemic disease resulting from the spread of gonorrhea) may occur.
Prognosis
- The prognosis for vaginitis is generally very good.
Patient Education
- Discuss further preventive efforts, including proper hygiene and toilet techniques, when appropriate. Remind patients that douching can spread a vaginal or cervical infection into the uterus increasing the likelihood of pelvic inflammatory diseases. Studies have also indicated that douching can be associated with endometritis.
- Educate patients regarding use of topical creams for treatment of vaginitis (eg, candidal vaginitis, bacterial vaginosis) as necessary.
- For excellent patient education resources, visit eMedicine's Yeast and Fungal Infections Center, Women's Health Center, and Parasites and Worms Center. Also, see eMedicine's patient education articles Vaginal Infections, Candidiasis (Yeast Infection), Understanding Vaginal Yeast Infection Medications, Female Sexual Problems, and Trichomoniasis.
Miscellaneous
Medicolegal Pitfalls
- In cases of suspected sexual assault or child sexual abuse, proper documentation may assist with possible subsequent legal action.
- Prior to treatment with any of the drugs that should not be used during pregnancy, determine possibility of pregnancy, test for pregnancy as appropriate, and maintain proper documentation.
More on Vaginitis |
| Overview: Vaginitis |
| Differential Diagnoses & Workup: Vaginitis |
| Treatment & Medication: Vaginitis |
 Follow-up: Vaginitis |
| References |
| Further Reading |
| « Previous Page |
References
[Best Evidence] Black CM, Driebe EM, Howard LA, Fajman NN, Sawyer MK, Girardet RG, et al. Multicenter Study of Nucleic Acid Amplification Tests for Detection of Chlamydia trachomatis and Neisseria gonorrhoeae in Children Being Evaluated for Sexual Abuse. Pediatr Infect Dis J. Jul 2009;28(7):608-613. [Medline].
Fredricks DN, Fiedler TL, Thomas KK, et al. Targeted PCR for detection of vaginal bacteria associated with bacterial vaginosis. J Clin Microbiol. Oct 2007;45(10):3270-6. [Medline]. [Full Text].
Angotti LB, Lambert LC, Soper DE. Vaginitis: Making Sense of Over-the-Counter Treatment Options. Infectious Diseases in Obstetrics and Gynecology [serial online]. Aug 7, 2007;Available at http://www.hindawi.com/GetPDF.aspx?doi=10.1155/2007/97424.
Sobel JD, Chaim W, Nagappan V, Leaman D. Treatment of vaginitis caused by Candida glabrata: use of topical boric acid and flucytosine. Am J Obstet Gynecol. Nov 2003;189(5):1297-300. [Medline].
Van Kessel K, Assefi N, Marrazzo J, Eckert L. Common complementary and alternative therapies for yeast vaginitis and bacterial vaginosis: a systematic review. Obstet Gynecol Surv. May 2003;58(5):351-8. [Medline].
[Guideline] ACOG Committee on Practice Bulletins--Gynecology. ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologists, Number 72, May 2006: Vaginitis. Obstet Gynecol. May 2006;107(5):1195-1206. [Medline].
American Academy of Pediatrics. 2009 Red Book Report of the Committee on Infectious Diseases. 28th ed. 2009.
Anderson MR, Klink K, Cohrssen A. Evaluation of vaginal complaints. JAMA. Mar 17 2004;291(11):1368-79. [Medline].
Barousse MM, Van Der Pol BJ, Fortenberry D, et al. Vaginal yeast colonisation, prevalence of vaginitis, and associated local immunity in adolescents. Sex Transm Infect. Feb 2004;80(1):48-53. [Medline].
Callahan DB, Weinberg M, Gunn RA. Bacterial vaginosis in pregnancy: diagnosis and treatment practices of physicians in San Diego, California, 1999. Sex Transm Dis. Aug 2003;30(8):645-9. [Medline].
Daniels RV, McCuskey C. Abnormal vaginal bleeding in the nonpregnant patient. Emerg Med Clin North Am. Aug 2003;21(3):751-72. [Medline].
Department of Health and Human Services, Centers for Disease Control and Prevention. Sexually Transmitted Diseases. Centers for Disease Control and Prevention. Available at http://www.cdc.gov/std/default.htm.
Gardner JJ. Comparison of the vaginal flora in sexually abused and nonabused girls. J Pediatr. Jun 1992;120(6):872-7. [Medline].
Hammill HA. Normal vaginal flora in relation to vaginitis. Obstet Gynecol Clin North Am. Jun 1989;16(2):329-36. [Medline].
Hampton T. High prevalence of lesser-known STDs. JAMA. Jun 7 2006;295(21):2467. [Medline].
Hardick J, Yang S, Lin S, et al. Use of the Roche LightCycler instrument in a real-time PCR for Trichomonas vaginalis in urine samples from females and males. J Clin Microbiol. Dec 2003;41(12):5619-22. [Medline].
Hillier SL, Nugent RP, Eschenbach DA, et al. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. The Vaginal Infections and Prematurity Study Group. N Engl J Med. Dec 28 1995;333(26):1737-42. [Medline].
Jenny C. Sexually transmitted diseases and child abuse. Pediatr Ann. Aug 1992;21(8):497-503. [Medline].
Karasz A, Anderson M. The vaginitis monologues: women's experiences of vaginal complaints in a primary care setting. Soc Sci Med. Mar 2003;56(5):1013-21. [Medline].
Kellogg ND, Parra JM, Menard S. Children with anogenital symptoms and signs referred for sexual abuse evaluations. Arch Pediatr Adolesc Med. Jul 1998;152(7):634-41. [Medline].
Mossad S. Common infections in clinical practice: dealing with the daily uncertainties. Cleve Clin J Med. Feb 2004;71(2):129-30, 133-8, 141-3. [Medline].
Pokorny SF. Prepubertal vulvovaginopathies. Obstet Gynecol Clin North Am. Mar 1992;19(1):39-58. [Medline].
Reid G, Bruce AW. Urogenital infections in women: can probiotics help?. Postgrad Med J. Aug 2003;79(934):428-32. [Medline].
Ryan KJ, Berkowitz RS, Barbieri RL. Gynecologic infections. In: Kistner RW, ed. Kistner's Gynecology: Principles and Practice. 6th ed. Mosby-Year Book; 1995:496-531.
Shapiro RA, Schubert CJ, Siegel RM. Neisseria gonorrhea infections in girls younger than 12 years of age evaluated for vaginitis. Pediatrics. Dec 1999;104(6):e72. [Medline].
Siegfried EC, Frasier LD. Anogenital skin diseases of childhood. Pediatr Ann. May 1997;26(5):321-31. [Medline].
Straumanis JP, Bocchini JA Jr. Group A beta-hemolytic streptococcal vulvovaginitis in prepubertal girls: a case report and review of the past twenty years. Pediatr Infect Dis J. Nov 1990;9(11):845-8. [Medline].
Swygard H, Sena AC, Hobbs MM, Cohen MS. Trichomoniasis: clinical manifestations, diagnosis and management. Sex Transm Infect. Apr 2004;80(2):91-5. [Medline].
Zeger W, Holt K. Gynecologic infections. Emerg Med Clin North Am. Aug 2003;21(3):631-48. [Medline].
Wilson JF. In the clinic. Vaginitis and cervicitis. Ann Intern Med. Sep 1 2009;151(5):ITC3-1-ITC3-15; Quiz ITC3-16. [Medline].
Keywords
vaginitis, vaginitis symptoms, bacterial vaginitis, vaginitis treatment, candida vaginitis, causes of vaginitis, vulvovaginitis, bacterial vaginosis, yeast infection, vaginal discharge, candidiasis, Candida albicans, trichomoniasis, Trichomonas vaginalis
