Red flags The following findings are of particular concern: Fever or pelvic pain Bloody discharge in postmenopausal women Fecal discharge (suggesting a fistula, even if not seen) Trichomonal vaginitis in children (suggesting sexual abuse) Interpretation of findings Often, the history and physical examination help suggest a diagnosis (see table Some Causes of Vaginal Pruritus and Discharge), although there can be much overlap.