Genital Tract Infections Flashcards
How can genital tract infections be categorised?
Non sexually transmitted
Sexually transmitted
What are the main 2 types of non sexually transmitted genital tract infections?
Bacterial vaginosis
Candidiasis
What is bacterial vaginosis and how does it commonly present?
It is caused by an overgrowth of mixed anaerobes.
It is the commonest cause of discharge and characteristically discharge is grey/white and has a fishy odour.
What are the amstel diagnostic criteria for BV?
- Grey/white discharge
- Fishy smell
- Vaginal pH greater than 4.5
- Clue cells* on microscopy
*squamous cell epithelial cells with bacterial adherent walls
What are the complications associated with BV?
Complications in pregnancy:
- Mid trimester miscarriage
- Preterm premature rupture of membranes
- Preterm delivery
What is candida infection and how does it commonly present?
It is a yeast like fungal infection caused by candida albicans.
It is very common found in up to 20% of women and is often asymptomatic.
If symptomatic presents with:
- Cottage cheese like discharge
- Vulval irritation, redness and itching
- Superficial dyspareunia and dysuria
Which factor predispose a women for candida infection?
Pregnancy
Diabetes
Immunosuppression
Previous antibiotics
How is candida investigated?
No investigations are usually necessary, diagnosis is on examination.
Can do swabs to rule out other infections and MSU to rule out urinary tract infection.
What is the treatment of candida?
Topical imazoles:
Clotrimazole (canestan)
Oral flucanazole
What is a Bartholin’s cyst and abscess?
It is when one of the bartholin’s glands becomes blocked forming a cyst.
There is then subsequent infection it is often multiple organisms but can be organisms from the perineum (E.coli) or STI’s (chlamydia or gonorrhoea)
Usually they occur unilaterally
What are the signs and symptoms of Bartholin’s cyst or abscess?
Cyst is a vulval swelling.
Abscess is a tender red fluctuant mass which occurs in the labia minor/majora at 5 or 7o’clock.
Other symptoms include fever and unilateral vulva pain.
How is a Bartholin’s cyst or access treated?
Simple cyst can be ignored if it is not causing any problems as it will resolve on its own.
Exception if >40 and query cancer risk needs excision and histology.
Abscess: Marsupialisation (it is made into a pouch so as not to become cystic and infected again)
