Clinical QuickieInfectious Disease
Vaginitis — BV vs Candida vs Trichomonas
Vaginal discharge is not one diagnosis.
Use symptoms + pH + testing
BV, Candida, and Trichomonas overlap in symptoms. Discharge character alone is not reliable enough to diagnose all three.
Candida is usually more inflammatory
Prominent pruritus/burning, vulvar erythema, and thick discharge support Candida; vaginal pH is often normal.
BV and Trich often raise pH
BV commonly causes thin homogeneous malodorous discharge; Trichomonas may cause irritation/discharge and requires STI-oriented management.
Do not keep empirically treating 'yeast'
Recurrent symptoms should prompt confirmation and consideration of cervicitis, STI, dermatitis, non-albicans Candida, or noninfectious disease.
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