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Health Issues

Vaginal Infections

Yeast infections are caused by the fungus Candida albicans, one of many fungi that reside harmlessly in the vagina, mouth, throat and skin. The slightly acidic chemical content of the vagina controls the balance between the bacteria and yeast that reside in the normal vagina. If the fragile balance between acidity and alkalinity is altered, the amount of yeast grows to the extent that a Candida infection (known as candidiasis) occurs. A similarly uneasy truce exists between “friendly” bacteria (lactobacilli) and “unfriendly” bacteria (anaerobes). In bacterial vaginosis, the anaerobes multiply at a rapid pace until they’ve all but displaced many of the lactobacilli. As in candidiasis, the vaginal ecosystem changes from acidic to alkaline. “Nobody is absolutely sure what causes the bacterial overgrowth,” says Dr. Meg Fisher, a pediatrician at St. Christopher’s Hospital for Children, in Philadelphia. Interestingly, although bacterial vaginosis is not transmitted via intercourse, sexually active women have a higher rate of infection—and higher still if they’ve been intimate with multiple partners.

Physical examination, including pelvic exam, and thorough medical history, plus one or more of the following procedures: Microscopic laboratory analysis of vaginal fluid (your pediatrician may refer to these tests as wet preparation and KOH preparation) to rule out infection.



How Vaginal Infections are Treated

Drug therapy: Yeast infections are managed with antifungal agents suchas butoconazole, clotrimazole, miconazole and tioconazole, which come in the form of creams, ointments and suppositories. Fluconazole can be given orally. The shortest course consists of a single dose, which is 80 percent effective.

For bacterial vaginosis, the antibiotics clindamycin and metronidazole are the mainstays of therapy.

Vaginal Infection Symptoms


Bacterial Vaginosis

Vaginal Yeast Infection

  • Grayish-whitish milky discharge
  • White, thick, curdlike discharge
  • Foul odor often described as "fishy"; most noticeable after
    sexual intercourse
  • No odor
  • Occasional itching and/or burning
  • Extreme itching and/or burning, especially when urinating
  • Inflammation, redness and swelling of the outer lips of the vagina (labia)and the surrounding skin (vulva)
  • Discomfort during and/or after sexual intercourse


Last Updated
Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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