[22F] With vaginal sores and recent BV diagnosis

Patient Description

A 22-year-old female presents with white and open sores on the vagina, which developed gradually over the past five days. The sores are painful, especially when walking, and there is a burning sensation during urination rated as 9 out of 10 in severity, accompanied by a severe itch. Warm baths provide some relief. The patient reports redness around the sores and a white, watery vaginal discharge. There are no accompanying fever, chills, or flu-like symptoms. This is the first occurrence of such sores. The patient has had a recent new sexual partner and was diagnosed with bacterial vaginosis (BV) five days ago. Her medical history includes previous diagnoses of BV, chlamydia, yeast infections, UTIs, and trichomonas. She has not been tested for herpes or other STIs since the onset of these symptoms. Current medications include Metronidazole (500mg, twice daily for 7 days) and a daily probiotic. There are no known drug allergies.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  • Bacterial Vaginosis (BV): You mentioned being diagnosed with BV recently. BV can cause vaginal discharge and irritation, but it typically doesn't cause sores. However, the irritation from BV might lead to scratching, which can cause sores or exacerbate existing ones.

  • Herpes Simplex Virus (HSV): Genital herpes can cause painful sores or ulcers in the genital area. These sores can sometimes resemble canker sores. Given your recent new sexual partner, it's important to consider this possibility. Testing for herpes can confirm this diagnosis.

  • Irritation or Allergic Reaction: The sores could be due to irritation from scratching or an allergic reaction to a product used in the genital area. This could include soaps, detergents, or other personal care products.

  • Other STIs: While less likely, other sexually transmitted infections could cause similar symptoms. It's important to get tested to rule these out.

Typical treatments for these conditions vary. BV is treated with antibiotics like Metronidazole, which you're already taking. Herpes is managed with antiviral medications, and irritation or allergic reactions are treated by avoiding the irritant and using soothing creams or ointments.

What you can do

  1. Continue Your Medication: Keep taking Metronidazole as prescribed for BV. It's important to complete the full course of antibiotics.

  2. Avoid Irritants: Use gentle, unscented products in the genital area to avoid further irritation. This includes soaps, detergents, and personal care products.

  3. Warm Baths: Continue taking warm baths to soothe the soreness and discomfort.

  4. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share this information with your healthcare provider. This can help in identifying patterns or triggers.

  5. Consult a Healthcare Provider: It's important to see a healthcare provider for a thorough examination and testing, especially for herpes and other STIs. They can provide a formal diagnosis and appropriate treatment.

What you should look out for

  • Worsening Symptoms: If the sores become more painful, increase in number, or if you develop new symptoms like fever or swollen lymph nodes, seek medical attention promptly.

  • Persistent Symptoms: If your symptoms do not improve with treatment or if they recur, follow up with your healthcare provider.

  • New Symptoms: Be alert for any new symptoms, such as unusual discharge, fever, or body aches, and report these to your healthcare provider.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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1 mo ago

People Also Ask

What are the common symptoms of genital herpes?

Common symptoms of genital herpes include painful sores or blisters in the genital area, itching, burning during urination, and sometimes flu-like symptoms such as fever and swollen lymph nodes. It's important to get tested to confirm a diagnosis.

Can bacterial vaginosis cause sores in the genital area?

Bacterial vaginosis typically causes symptoms like a fishy-smelling vaginal discharge and irritation, but it does not usually cause sores. However, irritation from BV might lead to scratching, which can cause sores or exacerbate existing ones.

How can I differentiate between an allergic reaction and an STI?

An allergic reaction often presents as redness, itching, and sometimes a rash in the affected area, usually after exposure to a new product. STIs, on the other hand, may cause sores, unusual discharge, and other systemic symptoms. Testing is necessary to accurately differentiate between the two.

What should I do if my symptoms worsen or do not improve with treatment?

If your symptoms worsen, such as increased pain, more sores, or new symptoms like fever, you should seek medical attention promptly. If symptoms do not improve with treatment, follow up with your healthcare provider for further evaluation and possible testing for other conditions.

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