Atlas of Colposcopy: Principles and Practice

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Cervicovaginal inflammation – Vaginal discharge  

During colposcopic examination, the character of the discharge in the vagina and that covering the cervix gives a fair indication of the nature and cause of infection.

  • Candida infection is characterized by curdy or cheesy and often sticky white discharge.

  • Trichomonas vaginalis infection is detected by frothy greenish or yellowish foul-smelling discharge.

  • Greyish discharge with fishy smell is commonly seen in bacterial vaginosis

  • An inflamed cervix (cervicitis) that appears red (beefy) and swollen with purulent discharge coming out of the external os is commonly seen in chlamydia or gonococcal infections. The columnar epithelium becomes oedematous and friable. Visualization of the endocervical canal becomes difficult because of profuse purulent discharge.

  • However, excessive normal vaginal discharge should not be confused with infection. Normal discharge will not be associated with symptoms or foul smell or any inflammation of the cervix or vagina. The amount and the consistency of normal vaginal discharge change with the phase of the menstrual cycle, age, pregnancy status, and use of oral contraceptive pills.

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