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Oral clindamycin for the patient and her partner
0%
0/33
Oral clindamycin for the patient
3%
1/33
Oral fluconazole for the patient and her partner
Oral fluconazole for the patient
94%
31/33
Topical metronidazole
Select Answer to see Preferred Response
The patient's discharge, pelvic examination, and findings upon microscopy are consistent with candida vaginitis. Oral fluconazole for the patient is an appropriate treatment. Candida vaginitis is the second most common cause of abnormal vaginal discharge. A thick, white, odorless discharge is characteristic. Symptomatic patients may experience pruritis, tenderness, erythema, and edema of the vulva. Oral fluconazole and or vaginal fungicidal creams are used as treatment. Hainer and Gibson review vaginitis. 75% of patients will have at least one episode of candida vaginitis in their lifetime. Risk factors include vaginal or systemic antibiotic use, diet high in refined sugars, and uncontrolled diabetes mellitus. Symptoms vary and are often non-specific. Mylonas and Bergauer review wet microscopy for the diagnosis of vaginal discharge. Noninfectious causes of abnormal vaginal discharge are uncommon. Discharge from candida vaginitis demonstrates white blood cells upon saline mount. 10% potassium hydroxide will reveal characteristic pseudohyphae. Illustration A shows a positive KOH test of a vaginal wet mount; the pseudohyphae of Candida albicans can be seen. Incorrect answers: Answers 1 and 2: Clindamycin is an appropriate treatment for bacterial vaginosis (BV). In BV, the patient and not her partner is treated. Answers 3: The patient's partner does not require treatment in candidal vaginitis. Answer 5: Topical metronidazole is an appropriate treatment for BV, but not for candidal vaginitis.
4.0
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