Inflammation of the Female Genital Tract Flashcards
Describe the 2 categories of inflammatory conditions of the female genital tract?
- Specific - ones are due to infection usually sexually transmitted
- Non specific - An inflammatory reaction, but negative for a microbiological agent
Give examples of sequelae of infections of the female genital tract?
infertility, miscarriages and cancer
Which structures are considered to be part of the lower genital tract?
vulva, vagina and cervix
What is the term for inflammation of the vulva?
vulvitis
What is the term for inflammation of the vagina?
vaginitis
What is the term for inflammation of the vulva + vagina?
vulvovaginitis
What is the term for inflammation of the cervix?
cervicitis
What is the term for inflammation of the endometrium?
endometritis
What is the term for the inflammation of the fallopian tubes?
salpingitis
What is the term for the inflammation of the ovaries?
oophritis
What is the term for the inflammation of the fallopian tubes + ovaries?
salpingoophritis
List common infections of the female genital tract?
- viruses - Herpes simplex, Human papilloma virus (HPV).
- bacteria - Gonorrhoea, chancroid, granuloma inguinale, lymphogranuloma venereum, gardnerella vaginalis
- syphilis
- Mycoplasmal infection
- Chlamydial infection
- Trichomoniasis (protozoa)
- Candidiasis
Name the microbial infections that are confined to the lower genital tract?
- Herpes simplex
- Chanchroid
- Lymphogranuloma venereum,
- Granuloma inguinale
- Candidiasis
- Trichomonas vaginalis
- Gardnerella vaginalis
Describe the epidemiology of candidiasis?
Common infection in women
- 10% of women thought to be carriers
In which physiological conditions is candidiasis considered to be enhanced?
- diabetics
- oral contraception use
- pregnancy
What is the clinical presentation of candidiasis?
- Causes leukorrhoea - white discharge
- pruritus - itching
- Lesions can be small to large white patches
How can candida organisms be visualized?
- wet mounts - a sample of vaginal discharge is observed by wet mount microscopy by placing the specimen on a glass slide and mixing with salt solution
- cervical pap smears
What is Trichomoniasis?
infection caused by Trichomonas vaginalis
- a large flagellated ovoid protozoan
What is the clinical presentation of Trichomoniasis?
- a purulent vaginal discharge and discomfort with pruritus
2. Vaginal or cervical mucosa is inflamed with a red appearance termed strawberry cervix
Organisms of Trichomoniasis can be visualised by?
wet mounts or cervical Pap smears
What is Gardnerella vaginitis?
infection caused by G. vaginalis
- gram negative coccobacillus
What is the clinical presentation of Gardnerella vaginitis?
Presents as thin milky discharge with a fish like smell
Gardnerella vaginitis is associated with?
shift in vaginal flora
- Replacement of normal lactobacilli by G. vaginalis
What do cervical smears + wet mounts of Gardnerella vaginitis show?
clue cells = coccobacilli adhere to squamous cells completely covering them
What is the clinical term for infections involving upper + lower genital tract?
pelvic inflammatory disease (PID)
Common causative pathogens of PID include?
gonococci, chlamydia and enteric bacteria
- Gonococci is the common cause of PID
Name situations in which PID can arise?
- as a complication of miscarriage or abnormal deliveries
2. sexually transmitted
What is the clinical presentation of PID?
- Pelvic pain
- Adnexual tenderness on bimanual palpation
- Cervical excitation tenderness
- Fever
- Vaginal discharge
- Septic shock - Severe cases
Describe the course of infection for Gonoccocal PID?
- Begins in Bartholin gland and other vestibular glands , or periurethral glands
- Cervix involvement is common but asymptomatic
- Organisms then spread upward through mucosal surface to involve tubes and tubo- ovarian regions
- For obscure reasons, the endometrium is usually spared
What is the clinical presentation of Gonoccocal PID?
an acute suppurative inflammation with abscess formation in severe cases
- Acute suppurative salpingitis
- salpingo-oophritis
- Tubo-ovarian abscesses can form
- Tubes can from a pyosalpinx
Non Gonoccocal bacterial PID results as a complication of?
- Induced miscarriage
- Dilatation and curettage
- Complicated deliveries
- Surgical procedures on the female genital tract
Organisms that cause non gonoccocal bacterial PID include?
- Streptococci
- staphylococcus
- coliform bacteria
- Clostridium perfringes
How does non gonoccocal bacterial PID spread?
lymphatics + veins
What are the complications of PID?
- Peritonitis
- Intestinal adhesions between bowel and pelvic organs
- Bacteremia which can produce endocarditis, meningitis
- Infertility with blockage of fallopian tubes
