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INFECTIOUS VULVOVAGINITIS Part 01

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  1. Candidiasis (Moniliasis)
  2. Bacterial Vaginosis
  3. Trichomonas Vaginalis

Symptoms

 

  1. vaginal discharge
  2. odor
  3. pruritis
  4. lower genital tract pain
  5. dyspareunia
  6. dysuria

Pathophysiology

 

  1. normal vaginal flora contains a balance of many bacterial organisms
  2. flora may be altered by
    • a change in the environment
    • introduction of a new pathogen
  3. result is an imbalance in the relative number of organisms

Candidiasis (Moniliasis)

 

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  1. Organisms : Candida albicans(90%), Candida tropicalis(< 5%), Torulopsis glabrata(< 5%)
  2. 25% of vaginitis

 

Symptoms

  1. asymptomatic (20%)
  2. begin in premenstrual phase image
  3. minimal whitish, curd-like, cottage-cheese vaginal discharge
  4. intense itch
  5. swollen, inflamed genitals
  6. vulvar burning, dysuria, dyspareunia

 

 

Predisposing factors

  1. pregnancy
  2. diabetes
  3. BCP
  4. antibiotic therapy
  5. immunosuppression (primary or secondary)
  6. if frequent recurrences, consider AIDS

 

Diagnosisimage

  1. KOH wet mount reveals hyphae and spores
  2. pH < 5

 

 

Treatment

  1. advise regarding good hygiene (e.g. cotton underwear)
  2. clotrimazole, butoconazole, miconazole, ticonazole or terconazole suppositories and/or creams for 1-day, 3-day or 7-day treatments
  3. oral fluconazole or ketoconazole
  4. symptomatic relief with douching, yogurt, acidophilus treat partners only if symptomatic
  5. treatment in pregnancy is nystatin (Mycostatin)
INFECTIOUS VULVOVAGINITIS Part 01 INFECTIOUS VULVOVAGINITIS Part 01 Reviewed by Radiology Madeeasy on August 23, 2010 Rating: 5
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