export_other gu tract infections Flashcards
What genus is predominant in normal vaginal flora during childbearing years?
Lactobacillus
Lactobacillus features
Gram-positive, microaerophilic/anaerobic rods
Cannot grow in urine (no UTIs)
How does Lactobacillus affect the conditions of the vagina?
Metabolize glycogen into lactate, resulting in vaginal pH of ~4-5
Factors that can alter normal vaginal flora
Age
Menstruation
Hysterectomy
Hysterectomy affects on normal vaginal flora
Particular increase in prevalence of Bacteroides fragilis
Also increase in E. coli and Enterococcus
Bacterial vaginosis (BV) cause
Overgrowth of anaerobic bacterial species
BV symptoms
May be asymptomatic
Discharge
Odor
Pain
Itching
Burning
BV diagnosis
Discharge
Clue cells
Positive “whiff test”
Elevated vaginal pH
Nugent score
Whiff test
Volatile amines produced by anaerobic metabolism
KOH added results in a strong, fishy odor
Nugent score
0-3 = normal (Lactobacillus dominant) 4-6 = intermediate (mixed)
7-10 = BV (absence of Lactobacillus, predominance of two other morphotypes)
Complications associated with BV
STD-susceptible
Increased transmission of HIV
More likely to develop other infections
Effects on baby during pregnancy
BV treatment
Oral metronidazole
Clindamycin
Recurrence is common
Vulvovaginal candidiasis (VVC) symptoms
Common fungal infection in women of childbearing age
Thick, odorless, white vaginal discharge
Two classifications of VVC
Uncomplicated
Complicated
Uncomplicated VVC
Sporadic or infrequent mild-to-moderate symptoms in otherwise healthy patient