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Abstract: Bacterial vaginosis is mainly an infection caused by dysbiosis of the normal flora in the vagina. The main clinical manifestations are vulvar itching, increased vaginal discharge and relatively thin, with a great fishy odor. The patient visited the clinic for 7 days for fishy odor of vaginal discharge and was diagnosed with bacterial vaginosis through physical examination, routine leucorrhea examination, TCT examination and HPV examination. Medication was given and after 10 days of systematic treatment, the discomfort disappeared and the disease was cured.
Basic information】Female, 29 years old
Type of disease】Bacterial vaginosis
Hospital】Guangzhou Huadu District People’s Hospital
Date of consultation】January 2022
Treatment plan】Medication (metronidazole suppositories, metronidazole tablets)
Treatment Period】10 days of outpatient treatment
Effectiveness】Discomfortable symptoms disappeared and the disease was cured
I. Initial consultation
On January 17, 2022, the patient, Ms. Song, visited the clinic for 7 days because of the fishy smell of vaginal discharge. 7 days ago, she had sexual intercourse, and found the fishy smell of vaginal discharge 3 days after sexual intercourse, so she washed the vaginal area with cleansing lotion, and the fishy smell was obviously reduced at that time. The vaginal area was not flushed and no medication was inserted 3 days before the visit. Physical examination: normal development, good general condition, normal body temperature, no abnormality in cardiopulmonary auscultation, full amplitude flat and soft without pressure pain. Gynecological examination: vulva was flushed, vagina was clear, discharge was thin, yellowish in color, fishy odor, vaginal mucosa was congested and edematous, cervix was smooth, no abnormal discharge in the cervical area, no abnormalities were palpated in the uterus and adnexal area. The preliminary diagnosis of bacterial vaginosis was made by routine laboratory examination of the white belt, B V (+), cleanliness degree 3; no intraepithelial lesions were seen by TCT; HPV examination was negative.
II. Treatment history
1. Drug treatment: The patient was instructed to douche the vagina with 1/5000 potassium permanganate solution to change the vaginal pH, followed by vaginal insertion of metronidazole pessary. At the same time, metronidazole tablets were taken orally for 3 days, which is recommended to be taken orally after meals to avoid causing gastrointestinal irritation.
2. Daily management: keep the vulva clean, change new underwear every day, and dry the cleaned underwear in the sun after boiling water; during the treatment period, prohibit sex and spicy and acidic food.
Third, the effect of treatment
After active clinical use, the patient’s symptoms disappeared completely, no vulvar itching, no local burning sensation of vagina and odorless vaginal discharge, and the nausea and anorexia disappeared after stopping the metronidazole tablets. By laboratory examination, BV was negative, cleanliness was 2 degrees, gynecological examination, vaginal discharge was not much, milky white, no odor, vaginal mucosa was not congested, edema, no local abnormality of cervix, no abnormality of uterine adnexa.
IV. Notes
We are glad that the patient is cured after the treatment, but the patient should strengthen the care of sexual life, especially if the male partner has long foreskin, the foreskin must be turned up and cleaned before sex, and strengthen the care of menstruation period, avoid having sex during menstruation. It is forbidden to wash the vagina with medication if there is no discomfort, as this may lead to dysbiosis of the vaginal flora and cause anaerobic infection. Once you have vaginal discharge odor or itchy vulva and yellow vaginal discharge, seek medical attention promptly to avoid unauthorized use of medication which may delay the condition and cause serious consequences.
V. Personal insight
Bacterial vaginosis is usually caused by dysbiosis of the vaginal flora. In this case, the patient did not seek medical advice after the clinical symptoms appeared, which delayed the course of the disease, and most bacterial vaginosis can be cured with topical vaginal medication. Therefore, once gynecological clinical symptoms appear, it is important to seek medical attention and use medication under the guidance of a doctor, not only to achieve timely treatment, but also to shorten the course of treatment.