Background: Background Vaginal microbiome is a key factor in mucosal homeostasis and immune regulation in the female reproductive tract. The disturbance of the lactobacillus-dominant flora can contribute to the colonization by opportunistic pathogens such as Pseudomonas aeruginosa. Even though the P. aeruginosa is already known to be a pathogen in many anatomical locations, its contribution to vaginal infection and its systematic immuno-nutritional changes have not been adequately defined. The sustained inflammatory response after infection through therapy might help to cause changed mucosal immunity and general micronutrient deficiency. Aims: This study developed to assess local inflammatory response and systemic micronutrient profiles of women who had been diagnosed of Pseudomonas aeruginosa vaginal infection in the past, five months after standardized treatment with antimicrobials, and control group healthy women. Methods: The case-control study was a 12-month study in Thi-Qar Governorate, Iraq. Two hundred aged 35-50 years women were recruited: 100 women with known history of culture-confirmed P. aeruginosa vaginal infection diagnosed 5 months ago (Group A) and 100 age-matched healthy controls (Group B). All the cases had gone through the same antimicrobial regimens and none of them had chronic illnesses. Vaginal samples were examined by ELISA of pH, count of leukocyte (WBC/HPF), IL-1 B, IL-6, IL-8, TNF- 4 and secretion IgA. The levels of serum zinc, copper, iron, calcium, and 25-hydroxyvitamin D were determined using standard biochemical procedures. Statistical tests were performed involving parametric and non-parametric tests, odds ratios estimation, logistic regression, and principal component analysis (PCA). Results: Women in Group A showed a statistically significant higher vaginal pH, leukocyte infiltration and higher levels of IL-1B, IL-6, IL-8 and TNF-a (all p < 0.001) than controls. There was a significant increase in IL-8 levels, which showed that neutrophil recruitment is persistent. Group A had much lower serum zinc, iron, calcium and vitamin D concentration, and higher levels of copper (p < 0.001). Deficiency of vitamin D was found in 60 percent of the cases compared to 30 percent of controls. Forest plot analysis showed a high likelihood of increased odds of zinc, iron, and vitamin D deficiencies by formerly infected women. Multivariate studies indicated clear clustering distance between groups, which indicated a unique inflammatory-micronutrient signature used with antecedent P. aeruginosa vaginal infection. Conclusions: Pseudomonas aeruginosa vaginal infection history in women results in a sustained inflammatory response in the area and pronounced changes in micronutrients in the system 5 months post-standardized therapy. These results imply that there is integrated inflammatory-nutritional phenotype, which can affect the post-infectious mucosal immune restoration. Additional longitudinal and interventional research is justified to delineate the cause and effect as well as therapeutic implication.