A 25-year-old woman, gravida 1 para 1, comes to the office due to malodorous vaginal discharge for the last 2 weeks. She tried overthe-
counter antifungals without improvement. Four weeks ago, the patient had a forceps-assisted vaginal birth with a prolonged
second stage of labor. The delivery was complicated by a third-degree laceration, which was repaired with sutures, and postpartum
endometritis, which was treated with intravenous antibiotics. After delivery, vaginal packing was placed for 24 hours to tamponade
traumatized vaginal tissue. During the pregnancy, the patient was diagnosed with vulvovaginal candidiasis. Her medical history
includes irritable bowel syndrome diagnosed at age 18. She takes no medications. Examination showsra small, red, velvety area on
the posterior vaginal wall with foul-smelling brown discharge Which of the following is the most likely diagnosis in this patient?
- QA Anal incontinence
- 0 B. Crohn disease
- 0 C. Exacerbation of irritable bowel syndrome
- 0 D. lncisional abscess
- 0 E. Rectovaginal fistula
- 0 F Retained vaginal gauze
- 0 G. T richomoniasis
- 0 H. Vesicovaginal fistula
0 voters