Clinical Case Database / Category: Case Based Discussion

Vaginal discharge

Publication details

James W Gray MRCP FRCPath
Foundation Years Journal, volume 2, issue 3, p.120 (123Doc Education, London, March 2008)


Infection is the most common cause of pathological vaginal discharge. The most common infections are bacterial vaginosis (BV) and candidiasis. Sexually transmitted diseases that may present with vaginal discharge include trichomoniasis, chlamydia and gonorrhoea. Because of the long-term morbidity and public health implications of these infections they should always be considered in women at risk of sexually transmitted diseases. Microscopy and culture of vaginal and endocervical swabs are the mainstay of investigation of vaginal discharge, but for some infections they are increasingly being superseded by nucleic acid amplification techniques. In this article the various infective causes of vaginal discharge, and their treatment, are discussed and recommendations for selection of appropriate microbiological investigations according to the clinical presentation are proposed.

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James W Gray MRCP FRCPath (Corresponding author)

Consultant Microbiologist
Department of Microbiology
Birmingham Women’s NHS Foundation Trust
Birmingham Children’s Hospital NHS Foundation Trust
B15 2TG


1. Macsween KH, Ridgeway GL. ACP Broadsheet No. 153. The laboratory investigation of vaginal discharge. J Clin Pathol 1998;51:564–567.
2. Smellie WSA, Forth J, Sundar S,et al. Best practice in primary care pathology: review 4. J Clin Pathol 2006;59:893–902.
3. British Association for Sexual Health and HIV . http://www guidelines.asp, accessed on 10th February 2008.


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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