Common Genital Symptom Syndromes Flashcards
What are some genital symptoms that people present with?
- Discharge from an orifice
- Pain from somewhere
- Rashes
- Lumps and swellings
- Cuts, sores, ulcers
- Itching
- Change in appearance
- Vague sense of things not being right
What can cause genital symptoms?
- STD
- Other microbial problem
- Non-microbial problem
STD vs Other microbial problem vs Non-microbial problem
STD
- Public and individual health problem.
- Treatable.
- Not always curable
- Micro-organisms involved
Other Microbial Problem .-Individual health problem -Treatable -Usually curable -Micro-organisms involved
Non-Microbial Problem
-Individual health issue
What microbial conditions of the genitals are not regarded as STDs?
- Vulvovaginal candidosis
- Bacterial vaginosis
- Balanoposthitis – anaerobic/candidal
- Tinea cruris
- Erythrasma
- Infected sebaceous glands
- Impetigo
- Cellulitis
- Other
What causes vulvovaginal candidosis?
- 90% Candida albicans
- Can be C. glabrata et al
- Usually acquired from bowel
How does vulvovaginal candidosis present?
If symptomatic presents as thrush
- Itch
- Discharge: classically thick, increased amount (cottage cheese)
Often asymptomatic carriage.
-Pathogenicity is triggered by a change in host environement
Who is at increased risk of vulvovaginal candidosis?
- Diabetes, oral steroids
- Immune suppression incl HIV
- Pregnancy
- Reproductive age group (oestrogen…glycogen = food for yeast)
How is vulvovaginal candidosis diagnosed?
Characteristic history
Examination findings
- Fissuring
- Erythema with satellite lesions
- Characteristic discharge
Investigations
- Gram staining (low sensitivity)
- Culture (low specificity)
How is vulvaginal candidosis treated?
Azole antifungals
- Clotrimazole
- Fluonazole
- Resistant cases= determine species and sensitivities
- Maintain skin and avoid irritants
What is the commonest cause of abnormal vaginal discharge?
Bacterial vaginosis (10-40% of women at any time)
How does bacterial vaginosis present?
-Asymptomatic in 50%
watery -Grey/yellow ‘fishy’ discharge
-May be worse after period / sex
-Sometimes sore/itch from dampness
What is bacterial vaginosis?
An imbalance of bacteria rather than an infection
What is the pathophysiology of bacterial vaginosis?
A biofilm problem
- Increased gardnerella / ureaplasma / mycoplasma /anaerobes
- Reduced lactobacilli
- Sexually transmissibility controversial
- Associated with vitamin D deficiency but just in black women
What possible complications are there from bacterial vaginosis?
- Associated with endometritis if uterine instrumentation / delivery
- Associated with premature labour
- Increases risk of HIV acquisition
How is bacterial vaginosis diagnosed?
-Characteristic history
Examination findings
-Thin, homogenous discharge
-Gram stained smear of vaginal discharge
