Vaginitis/Vaginosis Flashcards
Candida albicans, C. flabrata, and Gardnerella vaginalis, Mobiluncus spp and other anaerobes are all what?
Opportunistic microorganisms and agents of bacterial vaginosis (BV)
Are the BV organisms sexually transmitted?
For the most part they are not
Where are the BV organisms found?
In the normal flora of the vagina at any given time, but are normally present in low and harmless numbers
What is the key factor allowing overgrowth of Candida and the agents of BV?
Disturbance of normal flora, especially the gram positive lactobacilli but also normal flora that help maintain a low Ph and produce hydrogen peroxide
What is T. vaginalis?
A single cell protozoan, not a bacterium, it is considered a frank pathogen rather than a part of normal flora (it is sexually transmitted)
Does a single agent cause BV?
No
What are the agents of BV we should know?
Gardnerella vaginalis, Mobiluncus, anaerobes
What causes Candidiasis?
Candida albicans, C. glabrata: fungi not bacteria
What causes Trichomoniasis?
Trichomonas Vaginalis, a protozoan
What main symptoms are seen with Candidiasis, Trichomonal, and BV?
Discharge (all 3), Dysuria and itching (for C and T)
What is the discharge seen in Candidiasis?
Scant, white, clumped adherent plaques
What is the discharge seen in Trichomoniasis?
Profuse, yellow, homogenous or frothy
What is the discharge seen in BV?
Moderate, white or grey, adherent, homogeneous discharge that uniformly coats vagina
Does BV have inflammation?
No, Candidiasis and Trichomoniasis do
Do Candidiasis and Trichomoniasis have Leukocytes?
Yes, BV does not
What is cystitis characterized by?
Dysuria, suprapubic pain, polys in urine, significant numbers of bacteria in the urine
What is pyelonephritis characterized by?
Signs and symptoms of cystitis, significant fever, flank/back pain
What is Cervicitis characterized by?
Dysuria, mucopurulent discharge
Are BV, candidiasis, and trichomoniasis common?
Yes, very
How is BV diagnosed?
Foul odor (add KOH = whiff test), discharge typical a dirty white/gray, pH > 4.5 of discharge, presence of clue cells
How is Candidiasis diagnosed?
Vaginal itching, discharge: patchy white adherent clumps, discharge may have pungent but not foul smelling odor, pH 4.5 or below, yeasts and branching hyphae seen on wet mount w/ KOH
How is Trichomonas diagnoses?
Discharge: yellow-green/yellow, homogeneous and may be copious and frothy, pH > 4.5; Wet mount microscopic exam of discharge: trichomonads (size of PMNs) with twitching motility, presence of PMNs
How do you treat Trichomonas?
Oral metronidazole
How do you treat Candidiasis?
Topical and oral azoles
How do you treat BV?
Oral metronidazole
Do you treat sexual partners of Trich?
Yes, Metronidazole (not in BV or Candidiasis)
