Vaginitis and vaginosis Flashcards
How is lab dx made?
By microscopic or other rapid examination of the discharge
Agents of vaginitis?
Cadida albicans and C. glabrata –> referred to as candidiasis
Agents of vaginosis?
Gardnerella vaginalis, Mobiluncus spp.
How are these agents spread?
NOT sexually transmitted
Part of the normal flora of the vagina, but are typically present in low and harmless numbers
What is the key factor allowing overgrowth of Candida and the agents of BV?
Disturbance of the normal flora, especially the gram positive lactobacilli but also other normal flora that help maintain a lo pH and produce hydrogen peroxide
Factors that alter the make up of the normal flora?
Antibx tx Sexual Activity Douching Initial use of IUDs Onset of the menstral cycle pregnancy tight fitting undergarments
What is Trichomonas vaginalis?
A cause of vaginitis called trichomoniasis
- A single cell protozoan, not a bacterium. It is considered a frank pathogen
What is cystitis characterized by?
Dysuria
Suprapubic pain
Leukocytes in the urine
Significant numbers of bacteria in the urine
What is pyelonephritis characterized by?
Dysuria Suprapubic pain leukocytes in the urine Significant numbers of bacteria in the urine Significant fever Flank/back pain
Dx of BV?
Foul odor: release of amines (fishy odor) after the addition of KOH (the Whiff test)
Discharge typically a dirty white or gray
pH of discharge above 4.5
Presence of clue cells
What are clue cells?
Vaginal epithelial cells with adherent bacteria in wet mounts or gram stains
Dx of Candidiasis?
Vaginal itching (often extreme) Discharge: patchy white adherent clumps (cottage cheese exudate) Discharge may have pungent but not foul smelling odor Yeasts and branching hyphae seen on wet mount treated with KOH
Dx of Trichomonas?
Discharge: yellow, yellow green
Discharge; homogeneous, may be copious and frothy
Discharge: may be malodoru
