Vaginal discharge

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Bacterial vaginosis Vaginal candidiasis Trichomoniasis
Sexually transmitted? no no yes
Risk factors sexually active, new partner, IUD use sexually active, antibiotic use, pregnancy, corticosteroid use, diabetes, immunocompromised multiple partners
Asymptomatic 50% 20% 10-50%
Symptoms vaginal discharge with fishy odour vaginal discharge with itch and external dysuria or superficial dyspareunia vaginal discharge with itch and dysuria
Signs copious thin white or grey discharge white, clumpy, curd-like discharge with erythema of the vagina and vulva off-white to yellow frothy discharge with erythema of vulva and cervix, including "strawberry cervix"
Microscopy clue cells, abnormal bacteriology buddy yeast with pseudohyphae trichomonads
Whiff test positive negative negative
Treatment metronidazole or clindamycin antifungals metronidazole, and treat partner