Recurrent Infectious Vaginitis: A Practical Approach for the Primary Care Clinician

Med Clin North Am. 2024 Mar;108(2):373-392. doi: 10.1016/j.mcna.2023.08.017. Epub 2023 Sep 14.

Abstract

Recurrent infectious vaginitis can lead to significant morbidity, patient frustration, and health care costs. The most common causes are bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC); however, other infectious and noninfectious etiologies should be considered in patients with recurrent symptoms. A detailed history and physical examination with appropriate testing at the time of symptoms is critical to establishing a correct diagnosis. Management options for recurrent BV and VVC are limited. Complex cases including those with atypical symptoms, negative testing for common causes, refractory symptoms despite appropriate therapy or recurrences during suppressive therapy will require referral to specialist care.

Keywords: Bacterial vaginosis; Recurrent bacterial vaginosis; Recurrent vaginitis; Recurrent vulvovaginal candidiasis; Vulvar symptoms; Vulvovaginal candidiasis.

Publication types

  • Review

MeSH terms

  • Candidiasis, Vulvovaginal* / diagnosis
  • Candidiasis, Vulvovaginal* / drug therapy
  • Female
  • Humans
  • Primary Health Care
  • Vaginosis, Bacterial* / diagnosis
  • Vaginosis, Bacterial* / drug therapy
  • Vaginosis, Bacterial* / microbiology