Non STI Genital Syndromes Flashcards
What organisms can cause vulval vaginal candidosis?
Candida Albicans
Candida Glabrata
Give predisposing factors for thrush
Diabetes
Oral steroids
Immune suppression (HIV)
Reproductive age group: Glycogen increased on skin due to oestrogen which yeast use as food)
Pregnancy
How does thrush present?
Often asymptomatic carriage
Itch
Discharge
- Classically thick
- ‘Cottage cheese’
- But often just increased amount
How is thrush managed?
Azole Antifungals
- Clotrimazole
- Fluconazole
Avoid irritants
Treat dermatitis
How is thrush managed in pregnancy?
Intravaginal clotrimazole
What is the most common cause of abnormal vaginal discharge?
Bacterial vaginosis
What is bacterial vaginosis?
Imbalance/overgrowth of bacteria in the vagina, predominately anaerobic organisms such as gardnerella vaginalis, leading to a fall in lactic acid and increaisng the pH
Give risk factors for bacterial vaginosis
Multiple sexual partners, although is not an STI
Excessive vaginal cleaning (douching, soaps)
Recent antibiotics
Smoking
Copper IUD
How does bacterial vaginosis present?
Asymptomatic in 50%
Watery grey/yellow ‘fishy’ discharge
May be worse after period or sex
Sometimes pain, itch or discomfort from dampness but not usually associated
What is seen on microscopy in bacterial vaginosis?
Clue cells (epithelial cells with bacteria stuck in them)
How is bacterial vaginosis managed?
Advice and education on vaginal health
Oral metronidazole 5-7 days
What should be avoided with metronidazole?
Alcohol, can cause reaction
What complications are associated with bacterial vaginosis?
STI
Preterm delivery and premature rupture of membranes
Miscarriage
Postpartume endometriosis
What is the vaginal pH in bacterial vaginosis?
> 4.5
