Unusual causes of vaginitis (excluding trichomonas, bacterial vaginosis, and Candida albicans)

When patients consult a gynecologist with repeated symptoms that cannot be diagnosed and do not respond to usual therapies, unusual causes of vaginitis should be considered. These include hormonal considerations, such as increased leukorrhea, and possibly amebiasis. Careful travel history should be taken in such patients. The less common sexually transmitted diseases that may cause unusual symptoms and sores should also be considered. Noninfectious allergic contact will continue to be a problem owing to the continued marketing of vaginal products for a variety of cosmetic indications. The simple of dictum of "seek and you will find" will also exclude retained tampons and other foreign objects. Psychosocial support should be given to patients when all likely causes have been excluded or all our scientific diagnostic approaches have been exhausted.