[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-405186-105":59,"doc-detail-405186-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","making-the-diagnosis-vaginal-infections-differential-diagnosis-and-diagnostic-tests","Making the diagnosis - Vaginal infections - Differential diagnosis and diagnostic tests","","Vaginal infections commonly present with discharge, itching, and/or odor. In symptomatic patients, bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis are the three most frequent causes, and more than one condition may coexist. Accurate diagnosis relies on a problem-focused history, targeted physical examination, and laboratory evaluation. The material summarizes characteristic clinical findings and reviews current in-office, point-of-care, and laboratory diagnostic tests, including pH assessment, wet mount microscopy, and the whiff test, supported by a differential diagnosis table.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/making-the-diagnosis-vaginal-infections-differential-diagnosis-and-diagnostic-tests/405186/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/making-the-diagnosis-vaginal-infections-differential-diagnosis-and-diagnostic-tests/405186.png","ImageObject",300,407,{"name":92,"@type":93},"Alex Sinclair","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-05","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Which vaginal infections are most common in women with symptoms such as discharge, itching, or odor?","Question",{"text":113,"@type":114},"The three most common conditions are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. Some patients may have more than one infection at the same time.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What elements are included in the problem-focused history for diagnosing vaginal infections?",{"text":118,"@type":114},"The focused history covers the characteristics of discharge, sexual history, vaginal hygiene practices (including douching), and prior history of vaginal infections and STIs. Clinicians also ask about treatments already tried, outcome, timing of last normal menses, and any spotting or bleeding between menses.",{"name":120,"@type":111,"acceptedAnswer":121},"How is vaginal pH used to support a diagnosis?",{"text":122,"@type":114},"Normal vaginal pH is between 3.8 and 4.5. A pH below 4.5 supports physiologic discharge or vulvovaginal candidiasis, while a pH above 4.5 predicts bacterial vaginosis or Trichomonas vaginalis infection, with possible exceptions when infections coexist or specimens are contaminated.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},405186,1790740593,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},1099523882182,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Making the diagnosis: Vaginal infections  \nBy Beth Kelsey, EdD, APRN, WHNP-BC, FAANP  \nMost women experience at least one vaginal infection characterized by vaginal discharge, itching, and/or odor during their lives. In women who present with these vaginal symptoms, the three most common conditions are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. In some cases, more than one vaginal infection is present. A problem-focused history, physical examination, and laboratory evaluation are necessary for accurate diagnosis. The author describes characteristic findings for these vaginal infections and discusses currently available diagnostic tests.  \npostcoital spotting or bleeding, dyspareunia, and use of contraception. HCPs should review current medications and allergies.  \nThe physical exam includes in  \nspection of the vulva, vagina, and cervix. HCPs should evaluate the vulva and vagina for erythema, edema, and lesions. The cervix is inspected for signs of cervicitis that may be the source of abnormal discharge. HCPs should note vaginal discharge characteristics such as color, viscosity, adherence to vaginal walls, and presence of odor, and should collect a specimen of the discharge from a lateral wall of the vagina for evaluation under a microscope. If the patient has risk factors for an STI or signs of cervicitis (e.g., mucopurulent discharge, friability), HCPs should collect a specimen from the endocervix for chlamydia and gonorrhea testing. In-office diagnostic tests include measurement of vaginal pH, wet mount microscopy, and an amine odor test (whiff test). In addition, point-of-care and laboratory-based diagnostic tests are available. Table 1 lists signs, symptoms, and various in-office test results for the differential diagnosis of vaginal discharge.1-3  \nReview of diagnostic tests  \nAlthough a health history  \nby itself is unreliable for  \nmaking a vaginal infection diagnosis, it can provide valuable information to guide physical examination and laboratory test decisions. The focused health history includes a description of the characteristics ofthe vaginal discharge, a sexual history, vaginal hygiene practices (e.g., douching), and previous history of vaginal infections  \nand sexually transmitted infections (STIs). Healthcare providers (HCPs) should ask the patient whether she has used any medication or other products to treat her current symptoms, as well as the outcome of the treatment. In addition, HCPs should inquire about the date of the patient’s last normal menses and the presence of any spotting or bleeding between menses. A sexually active patient should be asked about  \nThe most common in-office tests used to aid in the diagnosis of vaginal infections are a pH test of the vaginal discharge, wet mount microscopic inspection, and a whiff test. Also available are organism-specific point-of-care tests, which have higher sensitivity and equal or higher specificity than those of the wet mount. In some cases, laboratory tests may be indicated for diagnosis.  \n[NPW](NPWomensHealtHcare.com)[omens](NPWomensHealtHcare.com)[H](NPWomensHealtHcare.com)[ealtHcare](NPWomensHealtHcare.com)[.com](NPWomensHealtHcare.com) A Supplement to Women’s Healthcare September 2019 5  \nTable 1. Differential diagnosis of vaginal discharge1-3  \n\n| Condition | Symptoms | Physical examination findings | In-office diagnostic test findings |\n| --- | --- | --- | --- |\n| Bacterial vaginosis | Thin, white vaginal discharge with a fishy odor that may worsen after sexual intercourse; itching and irritation are not common; up to half of women with bacterial vaginosis have no symptoms | Milky gray-white malodorous vaginal discharge, mildly adherent to the vaginal walls; no inflammation | • Vaginal pH >4.5\u003Cbr>• Whiff test result is positive\u003Cbr>• Wet mount: >20% of epithelial cells are clue cells, 0-1 WBCs per epithelial cell, lactobacilli reduced or absent\u003Cbr>• Point-of-care vaginal fluid sialidase test result is positive |\n| Trichomon","cbCaieejbGRUMwte","https://ap.wps.com/l/cbCaieejbGRUMwte","pdf",1179337,"English","# Review of diagnostic tests\n## Differential diagnosis of vaginal discharge\n## In-office and point-of-care diagnostic tests\n## Physical examination and specimen collection\n## Vaginal pH interpretation","[{\"question\":\"Which vaginal infections are most common in women with symptoms such as discharge, itching, or odor?\",\"answer\":\"The three most common conditions are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. Some patients may have more than one infection at the same time.\"},{\"question\":\"What elements are included in the problem-focused history for diagnosing vaginal infections?\",\"answer\":\"The focused history covers the characteristics of discharge, sexual history, vaginal hygiene practices (including douching), and prior history of vaginal infections and STIs. Clinicians also ask about treatments already tried, outcome, timing of last normal menses, and any spotting or bleeding between menses.\"},{\"question\":\"How is vaginal pH used to support a diagnosis?\",\"answer\":\"Normal vaginal pH is between 3.8 and 4.5. A pH below 4.5 supports physiologic discharge or vulvovaginal candidiasis, while a pH above 4.5 predicts bacterial vaginosis or Trichomonas vaginalis infection, with possible exceptions when infections coexist or specimens are contaminated.\"}]","Making the diagnosis - Vaginal infections - Differential diagnosis and diagnostic tests | PDF",1790555071,13]