Question
An infertile woman presents with yellow or green vaginal discharge, Bartholin gland cyst, and proctitis. What is the most probable diagnosis?
| A. | Syphilis |
| B. |
Trichomoniasis |
| C. |
Gonorrhoea |
| D. |
Candidiasis |
Show Answer
|
Correct Answer » C Explanation |
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The combination of:
- Yellow-green purulent vaginal discharge
- Bartholin gland involvement (Bartholin cyst/bartholinitis)
- Proctitis
- Infertility (suggesting pelvic inflammatory disease)
is highly suggestive of gonococcal infection caused by Neisseria gonorrhoeae.
The uploaded notes specifically mention:
- Purulent vaginal discharge as the main feature of gonorrhoea.
- Bartholin’s cyst/bartholinitis is commonly caused by gonococcal infection.
- Gonorrhoea is an important cause of pelvic inflammatory disease (PID) and hydrosalpinx, leading to infertility.
Explanation of Each Option
A. Syphilis — Incorrect
- Caused by Treponema pallidum.
- Presents with painless chancre in primary syphilis and generalized rash in secondary syphilis.
- Does not typically cause purulent vaginal discharge, Bartholin gland infection, or proctitis.
B. Trichomoniasis — Incorrect
- Caused by Trichomonas vaginalis.
- Characterized by:
- Frothy yellow-green vaginal discharge
- Strawberry cervix
- Vaginal itching
- Vaginal pH >4.5
- Does not commonly cause Bartholin gland cyst, proctitis, or infertility.
C. Gonorrhoea — Correct
- Caused by Neisseria gonorrhoeae.
- Clinical features include:
- Purulent yellow-green vaginal discharge
- Cervicitis
- Bartholinitis/Bartholin gland cyst
- Proctitis (especially with rectal involvement)
- Pelvic inflammatory disease
- Tubal infertility due to salpingitis
- The uploaded notes identify gonorrhoea as a cause of Bartholin’s cyst, purulent vaginal discharge, PID, and hydrosalpinx.
D. Candidiasis — Incorrect
- Caused by Candida albicans.
- Produces:
- Thick, curdy white vaginal discharge
- Intense vulval itching
- Dyspareunia
- Does not cause Bartholin gland cyst, proctitis, or infertility.