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Updated 03 August 2015

Answer: What's your diagnosis? – Case 21

Miss T suffers from a burning, itchy vagina with a slight discharge. Based on her history, the most likely diagnosis is a yeast infection.

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Miss T initially self-treated her burning, itchy and red vagina with citro-soda as she thought it might be a bladder infection. Although many of her symptoms are similar to that of a bladder infection, it seems as if the problem is probably confined to her vagina, involving other structures of the urinary tract like the bladder, ureters and kidneys.

Natural bacteria disturbed

Candida is the most common yeast infection. The vagina, under normal circumstances, has a slighty acidic pH to prevent overgrowth of bacteria and other organisms. This acidic environment is usually established by lactobacillus (a natural ocuring bacteria in the vagina). If, for any reason, the natural bacteria are disturbed, infections may follow.

By taking an antibiotic that was not prescribed for her, miss T most likely started the process of changing the pH of the vagina by disturbing the natural occuring lactobacilli. Candida can quickly grow, causing a uncofortable burning sensation, irritated skin and a slight discharge.

It is important to keep in mind that other conditions like STD's can also cause similar problems, and therefore a proper medical and sexual history is of vital importance. This includes HIV status.

Read: The deadly alliance of STDs and HIV

In Miss T's case excluding other causes is of particular importance as her discharge is usually associated with other types of infections (like bacterial vaginosis). Yeast infections typically have a cottage cheese-like discharge.

Other contributing factors

Treating a vaginal infection properly requires a correct diagnosis of the potential problem. Doctors will do a physical and vaginal examination to establish the cause. Occasionally, when the diagnosis is not apparent, or, after initial treatment, the problem persists, the doctor might consider doing laboratory investigations.

Treating a yeast infection can be done locally (in the vagina) with anti-fungal creams like clotrimazole or fluconazole. If the problem persists after treatment, more investigations will be needed to find if there are other contributing factors. 

Men can also suffer from yeast infections, and it can be spread from partner to partner. In Miss T's case her boyfriend, by using condoms, most likely did not get infected.

NOTE: Health24's on-site GP Dr Owen Wiese reveals new cases on Thursdays. The answer is posted with the story on Mondays, or you can get it in our Daily Tip – sign up here.

Previously on What's Your Diagnosis?

What's your diagnosis - Case 1: vomiting and weight loss

What's your diagnosis - Case 2: eye pain

What's your diagnosis - Case 3: strange behaviour and a bullet in the back

What's your diagnosis - Case 4: seeing odd things

What's your diagnosis - Case 5: mysterious lungs

What's your diagnosis - Case 6: runner with seizures

What's your diagnosis - Case 7: swollen knee

What's your diagnosis - Case 8: bloody semen

What's your diagnosis - Case 9: confusing neurological signs

What's your diagnosis - Case 10: diabetic teenager with unusual signs and symptoms

What's your diagnosis - Case 11:bruising with no apparent cause

What's your diagnosis - Case 12: severe tummy pain

What's your diagnosis - Case 13: severe sore throat

What's your diagnosis - Case 14:abdominal pain and swelling

What's your diagnosis - Case 15: the world is spinning

What's your diagnosis? – Case 16: numbness in forearm

What's your diagnosis? - Case 17: burning urine

What's your diagnosis? – Case 18: boy with persistent fever

What's your diagnosis? – Case 19: lady who can't lose weight

What's your diagnosis? – Case 20: chest pain next to breastbone

Image: Candida from Shutterstock

Dr. Owen J. Wiese is Health24's resident doctor. After graduating from Stellenbosch University with additional qualifications in biochemistry and physiology he developed a keen interest in providing medical information through the media.

 
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