Nontrichomonal Purulent Vaginitis: Clinical Approach

Although trichomonal vaginitis and cervicitis are responsible for most presentations of a frankly purulent vaginal discharge, nontrichomonal vaginitis and purulent exudate are being seen in an increasing number of cases. Purulent vaginitis remains poorly defined and largely ignored, with little increase in the amount of knowledge we have of this not infrequent entity. Accordingly, a variety of empirical therapies, often including multiple simultaneous measures, are prescribed. Considerable numbers of causes are now identified, and this review describes a step-by-step approach to diagnosis and management.