Genital malodor in women: a modern reappraisal.

Genital malodor is a common distressing complaint that brings a woman to her physician's office. Vaginal infections, primarily bacterial vaginosis and trichomoniasis, still remain the commonest causes and are relatively easy to diagnose and treat. However, in approximately one third of women who present with malodor, no cause is identified. Although data on the management of vaginal discharge are extensive, the management of genital odor beyond common vaginal infections remains poorly studied. This presents a frustrating situation for both the patient and her physician. Often, patients resort to home remedies and over-the-counter preparations, which, while providing short-term relief for some women, almost never address the cause and, in some cases, can exacerbate symptoms. In this review, we have attempted to consolidate the known and documented causes of genital malodor including the nonvaginal causes and provide case studies that will help clinicians understand the possible settings for the various causes. We also provide an algorithm for the management of this symptom beyond vaginal infections.

A case of high-level metronidazole-resistant trichomoniasis in pregnancy successfully treated.

The incidence of metronidazole-resistant trichomoniasis is approximately 5%. Resistance during pregnancy has not been reported. Untreated trichomoniasis in pregnancy can cause preterm labor, premature rupture of membranes, and low birth weight. We report a case of metronidazole-resistant trichomoniasis in pregnancy, successfully treated with a high dose of tinidazole.

A case of Conidiobolus coronatus in the vagina.

Conidiobolus coronatus is a zygomycete that commonly involves the rhinomaxillary area in humans and animals. Infections are reported mostly from West Africa and South East Asia. Vaginal involvement in humans has not been described before. We report a case of C. coronatus infection involving the vagina that was successfully treated.