This page has moved. Click here to view.

 

Vaginitis and AIDS

Vaginitis is the most common gynecologic problem encountered by primary care physicians. It may result from bacterial infections, fungal infection, protozoan infection, contact dermatitis, atrophic vaginitis, or allergic reaction.

Pathophysiology

Vaginitis results from alterations in the vaginal ecosystem, either by the introduction of an organism or by a disturbance that allows normally present pathogens to

Antibiotics may cause the overgrowth of yeast or they may cause pathogenic strains to dominate, giving rise to bacterial vaginosis. Douching may Vaginitis Vaginitis alter the pH level or selectively suppress the growth of endogenous bacteria, vaginitis vaginitis vagenitis, AIDS

Clinical Evaluation of Vaginal Symptoms

The type and extent of symptoms, such as itching, Vaginitis Vaginitis discharge, odor, or pelvic pain should be determined. A change in sexual partners or sexual activity, changes in contraception method, medications (antibiotics), and history of prior genital infections should be sought.

Physical Examination

Evaluation of the vagina begins with close inspection of the external genitalia for excoriations, ulcerations, blisters, papillary structures, erythema, edema, mucosal thinning, or mucosal pallor. The color, texture, and odor of vaginal discharge should vaginitis, vaginoses, vaginal infection be noted.

Vaginal Fluid pH

The pH level can be determined by vaginitis, vaginoses, vaginal infection placing pH paper on the lateral vaginal wall or immersing the pH paper in the vaginal discharge. A pH level greater than 4.5 often vaginitis, vaginoses, vaginal infection indicates the presence of bacterial vaginosis. It may also indicate the presence of vaginitis, vaginoses, vaginal infection Trichomonas vaginalis.

Saline Wet Mount

One swab should be used to obtain a sample from the posterior vaginal fornix, obtaining a "clump" of discharge. Place the sample on a slide, add one drop of normal saline, and apply a coverslip. Coccoid bacteria and clue cells (bacteria-coated, stippled, epithelial cells) are characteristic of bacterial vaginosis. Trichomoniasis is confirmed by identification of trichomonads--mobile, oval flagellates. White blood cells are prevalent.

Potassium Hydroxide (KOH) Preparation

Place a second sample on a slide. Apply one drop of 10% potassium hydroxide (KOH) and a coverslip. A pungent, fishy odor upon addition of KOH--a positive whiff test--strongly indicates bacterial vaginosis. The KOH prep may reveal Candida in the form of thread-like hyphae and budding yeast. Cultures are not routinely indicated in the initial evaluation of vaginitis.

Screening for STDs. Testing for gonorrhea and chlamydial infection should be completed for women with a new sexual partner, purulent cervical discharge, or cervical motion tenderness.

Differential Diagnosis

The most common cause of vaginitis is bacterial vaginosis, followed by Candida albicans. The prevalence of trichomoniasis has declined in recent years.

Common nonvaginal etiologies include contact dermatitis from spermicidal creams, latex in condoms, or douching. Any STD can Vaginitis, vaginoses, vaginal infection, infections produce vaginal discharge.

Bacterial Vaginosis

Bacterial vaginosis develops when a shift in the normal vaginal ecosystem causes replacement of the usually predominant lactobacilli

New Treatments