What causes green lumpy discharge despite taking medicines?

Question

Hello doctor,

I was having lumpy discharge, and the swab test was done, which showed moderate growth of Candida albicans. On the same day, I had a small lumpy discharge of pale green color before the test. I started taking the medicine called Itraconazole as suggested by the gynecologist. But on the seventh day, I again had a lumpy green discharge. The amount is very little, and it is pale green. I had told this to my doctor before the swab test. The urine test shows 10 to 12 epithelial cells are present, and there is a presence of few bacteria as well.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

You were diagnosed with a moderate growth of Candida albicans based on a vaginal swab, and treatment was started with Itraconazole along with Beclomethasone topical antifungal. The symptoms of itching and odor have resolved, which suggests that the Candida infection is mostly under control. However, you are still experiencing occasional pale green, lumpy, sticky discharge in a small amount, without any odor, pain, or itching.

This type of discharge is not typically caused by Candida alone and could suggest other possibilities such as bacterial vaginosis (BV), especially if the vaginal pH has shifted, though BV usually has a noticeable odor. It might also indicate a mixed infection like Candida along with Trichomonas vaginalis or Gardnerella vaginalis, a mild residual irritation after treatment, or, in rare cases, normal healing discharge if it is minimal and symptom-free.

Since the swab only detected Candida and did not test for other infections like BV or Trichomonas, the green discharge may be due to post-inflammatory healing, or a co-infection was missed because culture or PCR (polymerase chain reaction) testing was not performed. Your urine test shows 10 to 12 epithelial cells, which is slightly elevated but not enough to confirm infection; this could simply be contamination from vaginal cells. The presence of a few bacteria in the urine may suggest mild colonization, but it does not indicate infection unless you have symptoms like burning or frequent urination.

It is important to complete the full course of Itraconazole as prescribed. If the green discharge continues beyond 10 to 14 days, you should ask your doctor about repeating the vaginal swab using culture or PCR methods to check for Trichomonas vaginalis, Gardnerella vaginalis (BV), or resistant strains of Candida (non-albicans). A vaginal pH test may also help in identifying BV or Trichomoniasis.

After antifungal treatment, using probiotic vaginal suppositories such as those containing lactobacillus may help restore healthy flora. Meanwhile, avoid douching, scented vaginal products, and tight synthetic underwear. You should consult your doctor if the discharge increases in amount, becomes foul-smelling, or if you experience itching, burning, pelvic pain, or changes in your menstrual cycle, such as irregular or more painful periods.

I hope you are satisfied with my answer.

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