Guidelines for the Management of Sexually Transmitted Infections: 2. TREATMENT OF STI-ASSOCIATED SYNDROMES: 2.4. Vaginal discharge: Vaginal infection

Guidelines for the Management of Sexually Transmitted Infections
(2001; 88 pages)

Índice de contenido

PREFACE
1. INTRODUCTION
	1.1. Background
	1.2. Rationale for standardized treatment recommendations
	1.3. Case management
	1.4. Syndromic management
	1.5. Risk factors for STI-related cervicitis
	1.6. Selection of drugs
2. TREATMENT OF STI-ASSOCIATED SYNDROMES
	2.1. Urethral discharge
		2.1.1. Persistent or recurrent urethral discharge
	2.2. Genital ulcer
		Genital ulcer and HIV infection
		Inguinal bubo
	2.3. Scrotal swelling
	2.4. Vaginal discharge
		Cervical infection
		Vaginal infection
	2.5. Lower abdominal pain
	2.6. Neonatal conjunctivitis
3. TREATMENT OF SPECIFIC INFECTIONS
	3.1. Gonococcal infections
		Uncomplicated anogenital infection
		Disseminated infection
		Gonococcal ophthalmia
	3.2. Chlamydia trachomatis infections (other than lymphogranuloma venereum)
		Uncomplicated anogenital, endocervical or rectal infections
		Neonatal chlamydial conjunctivitis
		Infantile pneumonia
	3.3. Lymphogranuloma venereum
	3.4. Syphilis
		Early syphilis
		Late latent syphilis
		Neurosyphilis
		Syphilis and HIV infection
		Syphilis in pregnancy
		Congenital syphilis
	3.5. Chancroid
	3.6. Granuloma inguinale (Donovanosis)
	3.7. Genital herpes infections
		First clinical episode
		Recurrent infections
		Suppressive therapy
		Herpes in pregnancy
		Herpes and HIV co-infection
	3.8. Venereal warts
		Vaginal warts
		Cervical warts
		Meatal and urethral warts
	3.9. Trichomonas vaginalis infections
	3.10. Bacterial vaginosis
		Bacterial vaginosis in pregnancy
	3.11. Candidiasis
		Vulvovaginal candidiasis
		Vulvovaginal candidiasis in pregnancy
		Vulvovaginal candidiasis and HIV infection
		Balanoposthitis
	3.12. Scabies
	3.13. Phthiriasis (pediculosis pubis)
4. KEY CONSIDERATIONS UNDERLYING TREATMENTS
	4.1. The choice of antimicrobial regimens
	4.2. Comments on individual drugs
	4.3. Antimicrobial resistance in N. gonorrhoeae
	4.4. Antimicrobial resistance in H. ducreyi
5. PRACTICAL CONSIDERATIONS IN STI CASE MANAGEMENT
	5.1. The Public Health package for STI prevention and care
	5.2. Clinical considerations
	5.3. Education for primary prevention
	5.4. Education and counselling during an STI consultation
	5.5. Notification and management of sexual partners
	5.6. Access to services
6. CHILDREN⁶, ADOLESCENTS AND SEXUALLY TRANSMITTED INFECTIONS
	6.1. Evaluation for sexually transmitted infections
ANNEX. LIST OF PARTICIPANTS

Vaginal infection

Recommended syndromic treatment

• therapy for bacterial vaginosis (for details see section 3.10)

PLUS

• therapy for Trichomonas vaginalis (for details see section 3.9)

AND, WHERE INDICATED,

• therapy for Candida albicans (for details see section 3.11)

AT A GLANCE

Vaginal infection

For details, see sections 3.9 - 3.11

Drug options for BV	Drug options for TV	Drug options for Candida
Metronidazole	Metronidazole	Miconazole
	Tinidazole	Clotrimazole
		Fluconazole
Alternatives		Alternative
Clindamycin		Nystatin
Metronidazole gel
Clindamycin vaginal cream

Note

• Patients taking metronidazole should be cautioned to avoid alcohol.

FIGURE 6. VAGINAL DISCHARGE

FIGURE 7. VAGINAL DISCHARGE (SPECULUM AND BlMANUAL)

FIGURE 8. VAGINAL DISCHARGE (SPECULUM AND MICROSCOPE)

Notes:

1. KOH Test: 1 drop 10% KOH to reveal the amine odour (fishy)

2. Wet mount: smear on slide with 1 drop of saline and view at 400x