Genital Infection in Gynecology | Lecture Note

University:
California State University, Northridge
Course:
NURS 315 | Pharmacology
Academic year:

2025
Views:

241

Pages:

63
Author:

silvio letitiya

GENITAL TRACT INFECTIONS Presenter- Dr Zephania Loponu Letitiya Moderator- Dr W. Mutahi Introduction In young females Vagina is lined with simple cuboidal epithelium Ph is neutral Colonized by organism similar to skin commensals At puberty under the effect of oestrogen: Stratified squamous epithelium develops Lactobacilli become the predominant organism Ph 3.5-4.5 After menopause : Atrophic changes occur Bacterial flora similar to that of skin Ph again rise to 7 4 Physiological discharge It is important to differentiate normal physiological changes from true infections. Normal vaginal discharge White, become yellowish on contact with air Consist of desquamated epithelial cells, mucus, bacteria and fluid Form as transudate from the vaginal wall Physiological discharge increase due to : 1. Increased mucus production from the cervix in mid cycle under the effect of progesterone. 2. Pregnancy 3. Combined oral contraceptive pills Genital tract infection Upper Lower Bacterial Fungal Viral Parasite Vaginitis is the most common gynecologic condition encountered in out patient clinics. defined as the spectrum of conditions that cause vulvovaginal symptoms such as itching, burning, irritation, and abnormal discharge. The most common causes : bacterial vaginosis (40-45%) vulvovaginal candidiasis (20-25%) Trichomonias is (15-20%) 7 Bacterial vaginosis ➤Most common cause of vaginitis in premenopausal women ➤ Represents a complex change vaginal flora Decrease in lactobacilli Increase in gardnerella vaginalis, mycoplasma hominis, anaerobic G- rods ➤Exact mechanism by which change takes place is unclear Clinical Features 50% are asymptomatic Unpleasant, "fishy smelling" discharge Itching and inflammation are uncommon More prominent during and following menstruation Creamy or greyish - white vaginal discharge Amsel Criteria Homogenous, grayish-whitish discharge Vaginal pH > 4.5 Positive Whiff test Clue cells on wet mount There should be at least 3 criteria for diagnosing BV. Clue cells are the most reliable predictor of BV Wet mount Sample vaginal discharge from the posterior fornix PH Microscopy Leukocytes, lactobacilli, clue cells, yeast, or trichomonads Whiff test 10% КОН Characteristic fishy (amine) odor of BV