likely to detect the organism. treatment is with a one time dose of oral antibiotics, most commonly metronidazole or tinidazole. chlamydia and gonorrhea chlamydia and gonorrhea can also cause vaginal discharge, though more often than not these infections do not cause symptoms. the vaginal discharge in chlamydia is typically pus-filled, but it is important to note that in around 80% of cases chlamydia does not cause any discharge. gonorrhea can also cause pus-filled vaginal discharge, but gonorrhea is similarly asymptomatic in up to 50% of cases. if the vaginal discharge is accompanied by pelvic pain, this is suggestive of pelvic inflammatory disease (pid), a condition in which the bacteria have moved up the reproductive tract. other causes foreign objects can cause a chronic vaginal discharge with a foul odor. common foreign objects found in adolescents and adults are tampons, toilet paper, and objects used for sexual arousal. before puberty the most common reason pre-pubertal females go to the gynecologist is concern about vaginal discharge and vaginal odor. the causes of abnormal vaginal discharge in pre-pubertal girls are different than in adults and are usually related to lifestyle factors such as irritation from harsh soaps or tight clothing. the vagina of pre-pubertal girls (due to lack of estrogen) is thin-walled and has a different microbiota; additionally, the vulva in pre-pubertal girls lacks pubic hair. these features makes the vagina more prone to bacterial infection. the bacteria that are more commonly responsible for vaginal discharge in pre-pubertal girls are distinct from those in other age groups, and include bacteroides, peptostreptococcus, and candida (yeast). these can derive from the colonization of the vagina with oral or fecal bacteria. another cause of vaginal discharge in pre-pubertal girls is the presence of a foreign object such as a toy or a piece of toilet paper. in the case of a foreign body, the discharge is often bloody or brown.