-IBIS-1.5.0-
tx
reproductive system
vaginitis/leukorrhea
diagnoses

definition and etiology

definition:
Inflammation and/or infection of the vagina with possible concurrent inflammation of the vulva.

etiology:
Vaginitis typically occurs one of two ways:
• the overgrowth of a normal part of the vaginal flora, or the introduction of a foreign microorganism through sexual relations
» normal flora that can cause disease: yeast (often candida albicans): may also spread from the intestines or sexually; hemophilus vaginalis/gardnerella vaginalis: often called "nonspecific vaginitis".
» foreign microorganisms: Trichomonas vaginalis, Neisseria gonorrhea.
» in young girls it may be also caused by E. coli, strep, or staph, due to poor hygiene
• reaction to an external agent causing allergic or chemical reaction

signs and symptoms

signs and symptoms:
• Vaginal discharge: white and curdish (yeast); creamy white or off-white (gardnerella); greenish-yellow, frothy (trichomonas).
• Itching: may be severe.
• Odor: none (yeast and trichomonas); fishy (gardnerella).
• Vulvar irritation and redness: possible with all three infections; however, candida is typically the worst irritant, and can cause fissuring and swelling.
• Vagina: normal except for the presence of mild to extreme amounts of discharge.

lab findings:
• (+) Wet prep and/or culture for microorganism identification.
• Pap smear may show inflammatory signs

course and prognosis

While trichomonas, candida, and gardnerella are benign infections causing no severe or life-threatening pathology, they can cause significant and unrelenting morbidity. Trichomonas, in particular, should be treated in a sexually active woman to prevent her passing it on to other individuals. Conventional treatment usually consists of nystatin (yeast); metronidazole (trichomonas), and oxytetracycline (hemophilus). Women treated this way have a high recurrence rate (especially of yeast and hemophilus).

differential diagnosis

• Differentiate infectious cause.
• Foreign body: forgotten tampon.
• Malignancy.
• Differentiate allergic/irritant cause


footnotes