[19F] Concerns about persistent green/yellow discharge during Metronidazole treatment

Patient Description

A 19-year-old female has been experiencing green or yellow vaginal discharge for approximately 2 weeks. The discharge is described as thick and occurs in small amounts, accompanied by an abnormal and unfresh odor, similar to a previous episode of bacterial vaginosis (BV). The patient has been prescribed Metronidazole 500mg daily since May 2nd and has also recently started taking Adderall XR 20mg daily for ADHD. Despite 6 days of treatment with Metronidazole, the discharge color has not changed, raising concerns about the effectiveness of the treatment. The patient reports slight itching and irritation at the vaginal opening after starting Metronidazole. There is no reported severe lower abdominal pain or fever. The patient has been sexually active with the same partner without using additional protection and is on birth control (Nexplanon). No allergies or adverse reactions to medications have been reported. The patient's medical history includes ADHD, for which she was diagnosed at a young age.

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Arora's Assessment

What might be happening

Based on the information provided, it seems like you are experiencing symptoms related to Bacterial Vaginosis (BV) and a yeast infection. These are common infections that can cause changes in vaginal discharge, including color, consistency, and odor.

  • Bacterial Vaginosis: This is an imbalance of the normal bacteria in your vagina. Symptoms can include a thin, gray, white or green vaginal discharge, a fishy vaginal odor, vaginal itching, and burning during urination.

    • Treatment usually involves antibiotics, such as Metronidazole, which you are currently taking.

  • Yeast Infection: This is an overgrowth of a type of fungus called Candida. Symptoms can include itching and irritation in the vagina and vulva, a burning sensation during intercourse or while urinating, redness and swelling of the vulva, vaginal pain and soreness, and thick, white, odor-free vaginal discharge with a cottage cheese appearance.

    • Treatment usually involves antifungal medication.

What you can do

  1. Continue taking your prescribed medication as directed by your healthcare provider. It's important to finish the entire course of antibiotics even if your symptoms improve before you've taken all the pills.
  2. Avoid sexual intercourse until your symptoms have completely resolved, as sex can worsen your symptoms and make your condition more uncomfortable.
  3. Wear cotton underwear and loose-fitting clothing to keep the area around your vagina dry and prevent irritation.
  4. Avoid douching, as it can disrupt the balance of bacteria in your vagina and can cause or worsen BV.

What you should look out for

If your symptoms persist after you've finished your course of antibiotics, or if they worsen at any point, you should reach out to your healthcare provider. Also, seek medical attention if you develop new symptoms such as severe abdominal pain or fever.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with your healthcare provider for appropriate examinations, treatment, testing, and care recommendations.

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7 mo ago

People Also Ask

What are the common symptoms of Bacterial Vaginosis (BV)?

Common symptoms of Bacterial Vaginosis include a thin, gray, white, or green vaginal discharge, a fishy vaginal odor, vaginal itching, and burning during urination.

How long does it typically take for Metronidazole to treat BV?

Metronidazole typically takes about 5 to 7 days to treat BV, but it is important to complete the full course of antibiotics as prescribed by your healthcare provider.

Can taking Adderall XR affect the treatment of BV or yeast infections?

Adderall XR is not known to directly affect the treatment of BV or yeast infections. However, it is always important to inform your healthcare provider about all medications you are taking to avoid potential interactions.

What should I do if my symptoms do not improve after completing the antibiotic course?

If your symptoms do not improve after completing the antibiotic course, you should contact your healthcare provider for further evaluation and possible alternative treatments.

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