Vaginitis
Definition
Inflammation of the vagina.
Aetiology
caused by
Trichomonas vaginalis - a protozoal organism
Candida albicans - a fungus
Bacteria -
Hypoestrogenism - postmenopausal
Non-infectious vaginitis – an allergic reaction or irritation from vaginal sprays, douches, spermicidal products, soaps, detergents, or fabric softeners. - no infection.
Incidence
Trichomoniasis - most common
Clinical Manifestations
Trichomonas vaginitis
Sexually trnasmissible - men may harbour the organism in their urethra and prostate
Inadequate hygiene
Use of an infected person's towel, bath tub, clothes
Pruritus (itching)
Vaginal discharge - profuse, thin, creamy or slightly green
Irritating
Frothy
Dysuria
Urethritis
Increased frequency of micturition
Investigations
Examination of a wet film under microscope - moving T.vaginalis along with other bacteria(E.coli, cocci)
Culture
Treatment
Metronidazole 200 mg - tid - X 7 days
OR
Metronidazole 1 gm - bid X 2 days
Spouse to be treated simultaneously
Contraindicated in the first trimester of pregnance
Candidiasis (moniliasis)
Caused by gram positive fungus Candida albicans
Common in pregnancy, diabetes mellitus, after an antibiotic treatment for any other illness
Clinical manifestations
Profuse curdy discharge
Intense itching
Soreness and oedema of the vulva
Redness of the vulva especially labia minora and introitus
Excoriations (scratch marks)
White patches - adherent - removal → multiple petechial haemorrhagic areas
Investigations
Vaginal discharge - KOH added - microscopy - candidal hyphae and buds seen
Culture
Treatment
Ketoconazole ointment, ketoconazole pills - both partners treated
Miconazole or clotrimazole vaginal pessaries or vaginal creams
Gentian Violet
Treat Diabetes Mellitus
