Recurrent infectious vaginitis can lead to significant morbidity, patient frustration, and health care costs. The most common causes are bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC); however, other infectious and noninfectious etiologies should be considered in patients with recurrent symptoms. A detailed history and physical examination with appropriate testing at the time of symptoms is critical to establishing a correct diagnosis. Management options for recurrent BV and VVC are limited. Complex cases including those with atypical symptoms, negative testing for common causes, refractory symptoms despite appropriate therapy or recurrences during suppressive therapy will require referral to specialist care.
Competing Interests: Disclosure S. Tuddenham has been a consultant for BioFire Diagnostics, Roche Molecular Diagnostics, and Luca Biologics, receives royalties from UPTODATE, and has received speaker honoraria from Roche Molecular Diagnostics and Medscape/WebMD. She participates in research supported by donation of test kits to her academic institution by Hologic, United States. J.D. Sobel has been a consultant to Scynexis Pharmaceuticals and Mycovia Pharmaceuticals and receives royalties from UPTODATE. C. Mitchell has been a consultant for Ferring Pharmaceuticals and Scynexis. She receives research funding from Scynexis, royalties from Up to Date, and grants from the Bill and Melinda Gates Foundation, United States. G.M. Yazdy has no disclosures.
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