infections Flashcards
trichomonas vaginalis
STD
frothy yellow green vaginal discharge with offensive smell and itchiness
strawberry cervix
wet smear= motile flagellated protozoa
treatment= metro 500mg bd for 5-7 days/ 2 g single dose
trichomonas pregnancy
premature rupture of membranes
low birth weight
5% perinatally infection
candida
thick curdle white ITCHY vaginal discharge dysuria and superficial dyspareunia
KOH wet preparation reveal spores and pseudohyphae
TX= if symptomatic, clotrimazole 500mg pessary ±topicals;
fluconazole 150mg single dose CI In pregnancy
candida in pregnancy
very common
topical imidazole
bacterial vaginosis
commonest cause of vaginal discharge in premenopausal women
profuse white-grey offensive (fish smell)discharge +increased vaginal ph more than 4.5. KOH wet mount= +whiff test and clue cells under microscopy
tx= metro 500 bd for 5 days, 2g single dose/ clindamycin 2% cream for 7 days
bacterial vaginosis pregnancy
increased risk
mid trimester miscarriage
preterm rupture of membranes
preterm delivery
PID diagnosis
lower abdominal/ pelvic pain + uterine/ adnexal/ cervial motion tenderness
PID treatment
outpt: ceftriaoxone IM one dose+ azithromycin PO one dose/ doxycycline
ofloxacin for 14 days
inpt: cefoxitin + doxycycline for 14 days
clindamycin + gentamycin for 14 days
drainage of tube-ovarian abscess
persists after treatment
mass more than 4-6 cm
mass in midline cul-de-sac and drainable through vagina
PID complications
repeated infections, chronic pelvic pain, dyspareunia, ectopic pregnancy
infertility 50% after third episode
Fitz-hugh curtis syndrome
TSS diagnosis
fever more than 38.9, hypotension, skin findings, involvement of 3 organ systems
causes of death in TSS-
arrhythmia, cardiomyopathy, respiratory failure caused by ARDS، coagulopathy caused DIC
