Diagnosis: Bacterial Vaginosis (BV)
Bacterial vaginosis affects ladies who are at the age of reproduction. It can either be symptomatic or asymptomatic. Symptomatic BV results in vaginal malodor high vaginal pH, itching, and discharge ( Coudray & Madhivanan, 2020 ). It increases the chances of contracting STDs such as HIV, trachomatis, and herpes simplex virus-2 (HSV-2).
Plan
Diagnostics:
The physicians may ask the patient about the history of their vaginal infections and STDs. They can observe the vaginal secretions through a microscope for the overgrowth of aerobic bacteria. They can perform a pelvic exam or test the vaginal pH.
Delegate your assignment to our experts and they will do the rest.
Treatment:
Although there are numerous treatment options, metronidazole, Tindamax, and clindamycin have proven to be correctly working (Muzny et al., 2019). However, the infection is approximately 80% recurrent in every three months. Thus, it requires regular treatments.
Education:
Metronidazole, Tindamax, and clindamycin gels weaken latex condoms for over one week after application. The treatment should be done for as long as the doctor prescribes it to avoid recurrence that would occur sooner than expected (Tuddenham et al., 2019). A lactobacillus colonization self-help therapy will help re-establish a balanced vaginal environment to boost the period of BV freedom. The practice involves taking foodstuffs containing lactobacilli, such as yogurt.
Follow Up:
If the signs return soon after the doctor's prescription, further check-up will be necessary. Extended use of metronidazole therapy is a possible option (Lev-Sagie et al., 2019). The patient is advised to delay sexual relations until the discomfort is resolved, and the use of condoms will reduce the recurrence rate.
Differentials
Physiological Discharge
Leucorrhea discharge is a normal discharge in women, which does not require douching (Muzny et al, 2019); otherwise, it would result in severe infection—the discharge increases unusually in people with high blood pressure (HBP).
Lisinopril enzyme is 90-day medication for HBP that helps to inhibit the excess production of the discharge.
Women should undergo all the Basic Metabolic Panel (BMP) biochemical tests to ensure balance metabolism within 6 months.
Continuous rechecks for blood pressure after every two weeks of medication.
Women should be engaged in discussion concerning low sodium diets that would otherwise lead to HBP.
Urinary Tract Infection (UTI)
UTI is an illness that affects any part of the urinary system.
Weight reduction increases the kidneys' functioning process, which prevents UTIs (Brookheart et al., 2019). Women should ensure at least 5% weight loss for 3 months.
30-minute walk daily would work best.
People need to be educated on diet and exercise.
Atrophic vaginitis
Like any other part of the skin, vulva skin is affected by dermatoses such as psoriasis, lichen planus, and sclerosis (Brookheart et al, 2019). Vulvar disorders cause rashes and pain, especially with people with diabetes.
A 3-month intake of A1C helps to boost the hemoglobin cells to treat diabetes.
Increased amount of metformin help to treat type 2 diabetes.
Diabetic people should be referred to medical educators, ophthalmology, and podiatry on an annual basis.
Daily check for diabetes and proper care with glucose intake for those with diabetes.
People with atrophic vaginitis should return for lab checks for 3-4 weeks.
References
Coudray, M. S., & Madhivanan, P. (2020). Bacterial vaginosis—A brief synopsis of the literature. European Journal of Obstetrics & Gynecology and Reproductive Biology , 245 , 143-148.
Lev-Sagie, A., Goldman-Wohl, D., Cohen, Y., Dori-Bachash, M., Leshem, A., Mor, U., ... & Elinav, E. (2019). Vaginal microbiome transplantation in women with intractable bacterial vaginosis. Nature medicine , 25 (10), 1500-1504.
Brookheart, R. T., Lewis, W. G., Peipert, J. F., Lewis, A. L., & Allsworth, J. E. (2019). Association between obesity and bacterial vaginosis as assessed by Nugent score. American journal of obstetrics and gynecology , 220 (5), 476-e1.
Tuddenham, S., Ghanem, K. G., Caulfield, L. E., Rovner, A. J., Robinson, C., Shivakoti, R., ... & Brotman, R. M. (2019). Associations between dietary micronutrient intake and molecular-Bacterial Vaginosis. Reproductive health , 16 (1), 151.
Muzny, C. A., Taylor, C. M., Swords, W. E., Tamhane, A., Chattopadhyay, D., Cerca, N., & Schwebke, J. R. (2019). An updated conceptual model on the pathogenesis of bacterial vaginosis. The Journal of Infectious Diseases , 220 (9), 1399-1405.
