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Complaints of smell all over and also outside. Feeling thirsty. Havig dry tongue. Suffer sinus. cure?

Mar 2016
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Practicing since : 2011
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White, female, 49, chief complaint is a constant smell she is unable to describe. She has stated it smells like garlic, or almond, but not able to put her finger on it. She states her urine has a similar smell. I live with her and have not detected any new smells in the home. She states she smells it everywhere, including outside.

She has claimed to be very thirsty in the last 7 days. Her mouth is very dry and her tongue has a white coat. Her sinuses have been bothering her as well.
Posted Sat, 28 Sep 2013 in Women's Health
Answered by Dr. S Patra 1 hour later
Brief Answer:
Bacterial Vaginosis. Need proper treatment.

Detailed Answer:

Thanks for writing to us. I am trying to solve your problem.

According to clinical presentation, I can assume that she is currently suffering from Bacterial Vaginosis (BV) which is associated with fishy or garlic odor vaginal discharge. White coated tongue is mostly due to oral candidiasis. Here, gynecologist to conduct pelvic examination (with or without speculum) and do relevant investigations like STD profile, vaginal swab test, urine examination- routine, microscopic & culture. It will help to make a concrete diagnosis.

Here, certain predisposing factors are to be eliminated like diabetes, OCP or IUD, other foreign objects, concurrent practice of vaginal & anal sex, cervicitis or atrophic vaginitis, hormonal imbalance, poor genital hygiene etc.

It may be aggravated by using chemical substance like lubricant/ jelly with condom or soap/ detergent/ other bath products, causing repeated friction & irritation inside vagina.

TREATMENT: I treat my patient with metronidazole or same categorical drug (like Tinidazole/ secnidazole) for Bacterial Vaginosis. It can be taken as 2 gm single dose. Vaginal suppository at bed time can be given.

In mixed vaginal infection, AFS kit (combination of Azithromycin, Fluconazole & Secnidazole) is very much effective. Here, sexual partner also needs complete course of treatment.

For oral candidiasis, anti-fungal medication like fluconazole is the treatment of choice. Kindly, procure a complete prescription from your doctor.

Following life style changes are helpful to prevent Bacterial Vaginosis:

1) Take healthy diet with anti oxidant (like Vit-E/ C, selenium, zinc, lycopene etc) supplements. Drink plenty of water/ juice for better systemic circulation.

2) Do not touch/ wipe out genital area too much. Also avoid inserting objects or douching inside vagina.

3) Maintain genital hygiene with proper shaving & cleaning. Do regular physical exercise by means of jogging/ walking/ treadmill etc.

4) Wear only clean & cotton underwear. Don't wear any tight fitting cloths or pants to avoid repeated friction/ irritation.

5) Avoid using any type of chemical cosmetics or soap or condoms. Try to avoid any type of sexual activity for at least 1 month.

Hope, above said information is sufficient & very much helpful to you. If you have any further questions I will be happy to help.

Wish her good health and take care yourself.

Dr Soumen
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