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is it really BV or something else?
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An_249382 posted:
Had a UTI 11/1 right at the start of my period. I was treated with Cipro. Yeast infection came next. Did the 1 day creme. Didn't work. Went back to the Dr. She said I still had YI, gave me Diflucan (7 day course 1 pill 2x a day). Seemed like it helped some. Symptoms came back (pain, burning and irritation, especially when sitting). Did the 3 day creme...thought I had allergic reaction as everything swelled and was actually red down there. Went back to the dr. She test a quick BV test (told me the result in a hour) and said it was negative. wanted me to do difulcan again (even though yeast test came back negative). I was hesitant to do so after it didn't work and I don't have discharge, itching and b/c the test said no yeast. Went on a 3 day course of steroids as they thought pain and burning may be from reaction to the three day creme. Didn't really help. went back to the dr. She wants me to take the antibiotic for the BV (even though I don't have "fishy smell" and that one test was negative) and I asked why take the antibiotics if the test was negative and she said that sometimes the test does not pick up the BV and b/c I was starting my period (started like 1 or 2 hours after I had the test) it may not be accurate. I am in so much pain. I cannot get an appointment to an ob/gyn for and 1 1/2 weeks. have to continually put ice on my "area" while at work so I can sit. I have switched to all my laundry detergent, soaps (everything) to non-perfume no dyes (you get the picture), I am wearing cotton undies (and I cannot wear jeans at all - i am wearing very loose clothing) but I feel like my whole area is on fire and the pain is intense.. I really need some guidance as I don't want to take an antibiotic and get my body off balance even more especially if its not going to treat the problem. I have NEVER had this happen and have had many UTIs in the past followed by yeast infections. Sex has not even been an option since the beginning of all this as I can hardly sit. I really just need someone to kind of point me in the right direction or at least tell me what questions to ask these doctors so I can get some relief.
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Jane Harrison Hohner, RN, RNP responded:
Dear An: You are correct, it is unlikely that BV is the cause of the extreme irritation (pain & burning). It also sounds like you got no relief from the creams, longer course of Difulcan or the oral steroids.

Frequent "yeast infections" that do not respond to any of the prescribed treatments suggest a couple of POSSIBILITIES. First that yeast is not the culprit, or second that it is one of the atypical subtypes of yeast ("candida").

The easiest way to help unravel this question is to have the GYN do a yeast CULTURE the next time.If the culture is negative then yeast is not the cause. Some other conditions which can produce yeast type symptoms include:

1. Cytolytic vaginitis--this is an overgrowth of the beneficial, hydrogen peroxide producing lactobacili that help keep the vagina clear of undesirable bacteria. An overgrowth can produce an itchy, burning, irritating discharge.

2. Desquamative vaginitis--this causes irritation and a discharge. Under the microscope there are many immature vaginal skin cells (can look like atrophic vaginitis) and lots of white blood cells.. Originally treated with clindamycin, more currently it is thought to be an autoimmune condition liked to lichen planus.

3. Lichen sclerosus--this is a skin condition outside the vagina (usually between the vaginal opening and the anus) that can create intense itching and irritation.

4. Contact dermatitis--this would be from a change in tampons/pads, new bubble bath, etc. I would doubt this is your problem as you have already switched products.

If the yeast culture is positive, then the lab can identify which of the yeast subtypes may be the villain. Most of our yeast medications are developed for candida albicans --about 80% of yeast infections are due to this. The other 20% or so are uncommon subtypes (eg candid glabrata). To treat the less common subtypes clinicians may try boric acid vaginally or even painting with a gentian violet (very messy!).

Yours,
Jane


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