Mixed vaginitis: causes, symptoms, diagnosis, and treatment

Mixed vaginitis is a vaginal inflammation caused by two or more pathogens.


Causes

There are at least two pathogens, including facultative anaerobes, anaerobes, trichomonas, candida, aerobes, and facultative aerobes.


Signs and Symptoms

There are not typical symptoms. The main clinical manifestations are abnormal vaginal discharge and genital pruritus. Different pathogens result in different colors, traits, and odors of discharge.

In both single and mixed vaginitis, there are pruritus, mucosal congestion, abnormal discharge, and leukorrhagia. In mixed vaginitis, there are obvious vaginal burning sensation, poor cleanliness, elevated vaginal pH value, and decreased lactobacilli.

Mixed vaginitis persists for 2 - 3 months, while single vaginitis lasts for about 1 month.

There is higher recurrence rate in mixed vaginitis.


Diagnosis

If there are at least two pathogens detected or manifestations of two or more vaginitis, the disease can be diagnosed.


Treatment

The treatment regimen for bacterial vaginosis + vaginal trichomoniasis + vulvovaginal candidiasis is oral nitroimidazoles + topical antifungal drugs; local combination medication (nitroimidazoles + antifungal drugs such as clotrimazole); or oral combination medication (nitroimidazoles + antifungal drugs such as fluconazole).

The regimen for bacterial vaginosis + vaginal trichomoniasis is nitroimidazoles orally for 1 week, or in a single dose + vaginally.

The regimen for aerobic vaginitis + bacterial vaginosis or aerobic vaginitis + vaginal trichomoniasis is oral nitroimidazoles + anti-aerobic drugs.

The regimen for aerobic vaginitis + vulvovaginal candidiasis is oral or topical antifungal drugs + oral anti-aerobic drugs.