Vaginitis with intense vaginal pruritus, malodorous yellow-green discharge, and urethritis is most consistent with which infection?

• A. Bacterial vaginosis
• B. Candidiasis
• C. Gonorrhea
• D. Trichomoniasis

Answer: (D)

Recognize that this pattern points to an infection with Trichomonas vaginalis. The key clues are intense vaginal itching, a malodorous yellow-green discharge, and the tendency to cause urethritis. Trichomoniasis often presents with pruritus and a yellow-green, sometimes frothy discharge that smells unpleasant, and the urethra may be irritated as well, leading to dysuria. In contrast, bacterial vaginosis usually causes a thin gray discharge with a fishy odor and minimal itching; candidiasis typically produces itchiness with thick, white, cottage-cheese–like discharge and little or no odor; gonorrhea can cause urethral discharge and cervicitis but the discharge is typically purulent rather than the characteristic malodorous yellow-green vaginal discharge seen with trichomoniasis.