Vulvovaginitis - Study Note

Vulvovaginitis It refell to inflammation of vagiral genitalia vulva vulvilss infedron in femall -> MC genital trad women present with vaginal symptoms suchas abnormal discharge odoul & itching with or without offensive - 3 MC cause of vaginitis in premeno pantal wom ase Trichomoniasis, badelial vaginosis & Vaginal candidiasis 1) Trichomoniasis -MC-STI - caused by flagellated pasasile Trichomonas vaginalis - It has only trophozoite stage - No cyst Plagellated Ameplaid bod ↓ infective actively aplicouting form diagmoltic -found in tisser seedingstage Life cycle -Asymptomatic farmales - reservoir Human acquise by sexual route flagellated trophozoites after entry, transformy ins anoeboid foring which multiply in genital tract & cause efection they again transform badk to flagellate form that all discharged in vaginal -25-50%. Asymptomatic harboring the trophozoites& Con transmit the infection. - whellas othes develop escase oster IP 4-28 days * Acute Infedion (vulvovaginitis) -Adhesis prote helpen attachment to the vagined, - famalll Mc afveiled - Vulvovaginiles Epithelium -chasaddized by thin profuse foul smelling putarial Vaginal discharge Discharge may be frothy (1090 of cases) & green colos mexed with puss cous Yellowity - strawbelly appasaure of vaginal mucosa -2% is colpitis maculatis Small punctale hemorrhagle spots on vaginal & celvical muscasa dyutia, lowel abd pain, -In moles-non gonococcal allthritis nor email + Chronic infection - Disease is mild with pouses & pair coitus, Vo is scatty, Mixed & mucus complicatio - ↑ risk of transmission HIN, EHSVII - low birth weighl Endomdritus, infertility -Direct microscopy - vaginal urethral discharg as prostatic secredy 9) wet (Saling) count - 40-80% secsitivity ii) Giemsa stain DFA (Dsreel suitescend Ab test-70-9040ssersitentry cultuse-gold std for diagness-75-960 Ag detection - ICT & ELISA - Ab detection - ELISA - Molecullos method -night sensitive Treatment Metronidazole or tinidazole Prevention. -56cabrand of baty sexual partnes -Safe sex -Audid with infected *Bactesial Vaginosis womens of reproductive age This condition is associated with an alteration of Norma Vaginal flora which is as follows isi intre conc -Gardnerella vaginalis -Normal isolated from genital trout-low in No -But in vaginosis ↑ - Mobiluncus (motile, curved, gran-valiable or goumnegalle azadobic rodd) Mycoplasma hominis 2 coute of lactobacilli Clactobacilli maintain accdec ply the vagina, so Rish factorhibiting growth of pathogenic organisin - Chlamelia trachomatis, N. gonorrhea Vaginal douching - unprotected vaginal rulescousse No associaled uflammation Amsel is criteria 19 nically diagnosed by Amsel's criterio PH more than 4.5 •Sligest - Modelale I thin (down viscous), while homogenay - Vaginal dischalge Pichy ads-unediate plies miring with 10% HOн - clue cells LAB -Nugent Score - Done by conting Givaginalis, Mobikunu E lactobacilus present - Score more or equal to 7 is dragut - Cultull - Enriched media - chotiolate agus BH I booth with selen - gram-ve Identifical - MALDI-TOF & VITEK - Broad range PCR Freulumet-metronidazoll Vaginal candidiasis Candida Albicam -MC characteristics- pruritos, crythema vaginal distralge lowP19 less than 4.5 vulvovaginal dysulia, soreness Risk factor -Pregnancy, hormone replacement, steroid, diabetis في usmonocompromised 2AB- cultull, vaginal se cocalion SDA, VITEK os MALDI-TOF, gelen tubelest Freabret-fluconazole or itraconazole Clot@mazoll