Genitalian Infections In Gynaecology Flashcards
What is trichomas vaginalis?
Flagellate protozoan –> severe vulvovaginitis
Sexually transmitted
Can cause UTI
S&S
Vulval sorenes and itching
Foul smelling vajj discharge, smts frothy yellowish green.
Dysuria and abdo discomfort
Asymptomatic carriers
Appearances of strawberry cervix due to the presence of punctate haemorrhages
Diagnosi- miscroscopy of vaginal discharge + culture- diamond medium
Both partners treated and screen for STDs
Metronidiazole in a single dose-2g or 400mg twice daily
Tretm fail: if 1 partner not treated.
Whats bacterial vaginosis?
Foul smelling vajj discharge w/o inflammation.
Due to growth &⬆️ in anaerobic species, ⬇️ in lactobacilli in vajj flora, makimg it more alkaline- 4.5-7,
Organisms: mycoplasma hominis,
S&S
Fishy malodours vajj discahrge
Asymptomatic carriers
More prominent during & following menstruation
Creamy or greyish- white vajj discharge commonly adherent to the walls of the vagina.
Management
Metronidiazole-twice daily-400mg- 5 days
If in pregnancy in 1st trimester- can cause late 2nd trimester miscarriage
Whats gonorrhoea?
STD- gram -ve diplococcus Neisseria gonorrhoea
Developing world.
Men- urethritis
Infects mucuc membranes of genitalia - cuboidal(endocervical) & columnar (urethral) mucosa.
Anal& oral inter course- rectum & orophanageal mucus membranes.
S&S
Asymptomatic, ⬆️ vajj discharge with lower abdominal/pelvic pain
Dysuria with urethral discharge
Proctitis w/ rectal bleed, discharge and pain
Systemic complications- bacteraemia, acute,
Monoarticular, septic arthritis.
Diagnosis: culture and endocervical swab
NAAT tests- antibiotic sensitivity
Treat: ciprofloxacin, IM ceftriaxone or oral cefixime.
Whats chlamydia? How is it treated?
Chlamydia trachomatis
Most common STD in developed world
Asymptomatic but urethritis and vaginitis occur.
Periph complications- pelvic infx–> silent–> tubal damage –> subfertility +- chronic pelvic pain.
Can also cause Reiters syndrome triad-urethritis, conjuctivitis and arthritis.
Nucleic acid amplification tests (NAAT) e.g. Polymerase Chain Reaction (PCR) can be used on urine for screening
Treatment- azithromycin and doxycycline.
What is vulvovaginal candidiasis?
Common
By- candida albicans 80-92% of cases
Diploid fungus
Common commencal in gut flora
Use vaginal /perineal swabs
If asymptomatic and pregnant- no tratment.
Topical imidiazoles- okay, not oral if pregnant.
Signs amd symptoms
Vulval itching & sorenes, thick curdy vajj discharge,
Dyspareunia + dysuria
Vulval oedema, vulval exoritation, redness amd erythema
Normal vaginal pH
