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Bacterial Vaginosis

• Most common vaginitis
• Caused by an imbalance in the ratio of normal vaginal flora
• Predominant organism: LACTOBACILI
• Alkaline vaginal pH:
• G. vaginalis
• Mobiluncus spp.
• Prevotella spp.
• Porphyromonas
• Peptostreptococcus
• Mycoplasma hominis
• Ureaplasma

Bacterial Vaginosis Diagnosis: Wet mount: Present: Clue cells Absent: WBC & Lactobacilli Amsel’s Diagnostic Criteria of BV 1.Presence of clue cells Gram stain Treatment: Metronidazole Clindamycin cream . white.Thin.Positive amine test 4.Alkaline vaginal pH 3. homogenous discharge 2.

strawberry cervix (punctuate hemorrhages) • Males: urethritis.Trichomoniasis • Vaginal parasitic infection • Causative agent: Trichomonas vaginalis • Sexually transmitted parasite • Females: vaginitis. usually asyptomatic • Coinfection occurs with gonorrhea and chlamydia .

Trichomoniasis • Clinical Sypmtoms • Green-yellow frothy vaginal discharge • Malodor • Pruritus • Irritation • Dysuria • Dyspareunia • Vaginal mucosa erythema • Strawberry cervix • Diagnosis • Wet mount – visualization of motile parasite • Presence of WBC & Lactobacilli • Alkaline vaginal pH • Positive amine test • Culture: Diamond’s Medium • Affirm VPIII • OSOM trichomonas rapid test • Treatment: • Metronidazole • Tinidazole .

ovulation. menopause) • Diabetes mellitus • Iron deficiency • HIV infection • Important Factor: Estrogen .candidiasis • Also know as Vulvovaginal Candidiasis • Causative Agent: yeast Candida • Candida is a part of normal flora • Causes of environment imbalance • Use of broad-spectrum antibiotics • Oral contraceptives • Estrogen replacement therapy • Hormonal changes (pregnancy.

candidiasis • Clinical Symptoms • Itching/burning sensation • Dyspareunia • Dysuria • Diagnosis • Thick. curd-like discharge • pH remains normal • Gram stain: • Budding yeast • Pseudohyphae • Increased number of WBC & lactobacilli • Large clumps of epithelial cells • Treatment • Azole anti-fungal medication . white.

squamous cells • Treatment: clindamycin .Desquamative inflammatory Vaginitis • Profuse purulent vaginal discharge • Vaginal erythema • Dyspareunia • Associated with beta hemolytic gram positive streptococcus • Result of decreased estrogen • Infection secondary to atrophic vaginitis • Diagnosis • Alkaline pH • Amine test negative • Gram stain: • Increased WBC. RBC. • Occasional parabasal.

Atrophic vaginitis • Found in postmenopausal women • Due to reduced estrogen production • Altered vaginal environment • Alkaline pH • Amine test negative • Clinical symptoms • Vaginal dryness • Soreness • Dyspareunia • Inflamed • Purulent discharge • Gram stain similar to DIV .

Additional tests • Fetal fibronectin • Amnisure test .

Fetal Fibronectin Test • Detects Fetal Fibronectin (fFN) • Present only in the first 24 weeks of pregnancy • Symptoms of preterm delivery: • Change in vaginal secretion • Vaginal bleeding • Uterine contractions • Abdominal/back discomfort • Pelvic pressure & cramping • Antibody (reagent): FDC-6 • Assay: • ELISA • Rapid fFN Cassette .

05 – 0.Amnisure Test • Detect fetal membrane rupture – leakage of amniotic fluid • PAMG-1 • Protein with high concentration in the amniotic fluid • Normal values: 0.22mg/mL • 3mg/mL – present in vaginitis • 2000-25000mg/mL – rupture of fetal membrane • Immunochromatograph method .