Page 278 - Learnwell EVS

ormal vaginal discharge

Case management

P atient com plains
of v ag inal d isch arg e
or v ulv ar itch ing /burning ,

etc.

T ake h istory, exam ine and
assess risk factors

Abnorm al d isch arg e Look for anoth er
is present?
N O g enital d isord er.
YE S If present, treat
appropriately.

If not, reassure th e patient.

Lower abd om inal pain or Y E S S ee Lower abdominal pain,
cerv ical m otion tend erness? pag e 239

NO

Risk assessm ent positiv e YE S Treat for cervicitis
(see below) AND bacterial vaginosis
OR AND trichomoniasis

purulent cerv ical
d isch arg e d etected ?

NO Vulv ar oed em a, th ick YE S In addition,
d isch arg e, eryth em a, treat for
Treat for bacterial excoriations present?
vaginosis candidiasis

AND trichomoniasis

Cerv icitis m ay be d ifficult to d iag nose. W h en in d oubt, ad m inister treatm ent for

cerv icitis to wom en w ith abnorm al v ag inal d isch arg e and any of th e follow ing risk

factors:
– U reth ral d isch arg e in th e partner
– Context of sexual v iolence or prostitution
– N ew partner or m ore th an one partner in th e preced ing 3 m onth s

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