VAGINAL INFECTIONS

Halima Nazar
Faculty of Eastern Medicine

HAMDARD UNIVERSITY

Vulvovaginitis, vulvitis, and vaginitis

Are general terms that refer to the inflammation of the vagina and/or vulva

Normal vaginal flora

vagina harbor different bacteria eg lactobacilli which maintain an acidic environment (lowpH), which is a natural disinfectant that acts to maintain the normal balance of organisms in the vagina that is hostile to disease bacteria Any condition that changes the vaginal acidity or disturb the normal bacteria in the vagina may predispose to an infection.

Causes of vulvovaginitis
Fungal Parasitic Bacterial Candida vulvovaginitis Trichomonal vulvovaginitis Bacterial vaginosis Chronic purulent vaginitis caused by gram-positive cocci Atrophic vaginitis caused by low estrogen levels Contact vaginitis caused by allergic or irritation or injury response from things such as spermicidal products, condoms, soaps, and bubble bath

vulvovaginal candidiasis," "candidal vaginitis," "monilial infection," or "vaginal yeast infection

In 80-90% of the cases, is caused by an overgrowth of the yeast Candida Albicans In 10 20 % is caused by Candida glabrata or candida tropicalis

Candida vulvovaginitis
Itching, soreness, pain on passing urine , thick, curdy, white (like cottage cheese) vaginal discharge . Vulvar swelling

Candida albicans
Leading cause of disseminated fungal disease Important nosocomial pathogen Diseases range from superficial infections to deep seated mycoses

Clinical syndromes. A. Cutaneous.

1. Dermatitis. 2. Onychomycosis (nails) 3. Paronychomycosis (nail beds). 4. Otitis externa.

B. Mucosal. 1. Vaginitis. 75% of all women at some time. Some recurrent. 2. Oropharyngeal (thrush). 3. Esophageal. 4. Perianal., balanitis C. Chronic mucocutaneous candidiasis. Heterogenous collection of clinical syndromes characterized by extensive, chronic, generally antifungal treatment-resistant superficial infections of skin, nails, and mucous membranes, virtually always without deeper invasion or dissemination.

D. Vaginal
1. White discharge. 2. Offensive smell 3. Irritation 4. Vaginal redness

Trichomoniasis
it is usually sexually transmitted disease. This means that the disease is passed from person-to-person only by sexual contact. in rare instances it has been passed through wet towels, washcloths or bathing suits. Trichomoniasis is primarily an infection of the urogenital tract; the urethra is the most common site of infection in men, and the vagina is the most common site of infection in women.

Trichomoniasis

Complication
Candidiasis Vaginitis Urinary tract infection Septicemia Endocarditis Pneumonia Carsinoma Trichomoniasis
Cellulitis following hysterectomy premature labor Infertility cervicitis Carsinoma

Incidence of different vaginal infections

Syndrome Urethritis Vaginal Discharge Genital Ulcer Disease PID Bubo Balanitis Epidydimo-orchitis Genital Warts Other STDs Total Female 32640 2263 4025 100 630 458 40116 Male 15382 4325 602 1160 386 831 874 23560 Total 15382 32640 6588 4025 702 1160 386 1461 1332 63676

Burden of Specific infection

STD Syndromes Relative Prevalence of Syndromes* 24.2% Estimated no. of Episodes 15282 Prevalence of Aetiological Agents** 71% GC infection 28% CT infection 16% Primary Syp. 24% Chancroid 50% G. herpes 28% Trichomoniasis 65% Candidiasis 33% GC Cervicitis 21% CT Cervicitis 45% GC/CT Cervicitis Estimated no. Cases of Spec. Disease 10850 4279 1049 1574 3280 9147 21233 10780 6860 14700

Urethritis

Genital Ulcer

10.3%

6559

Vaginal Discharge 51.3%

32666

Total no. of STD episodes : N = 63676 * Information obtained from the Sentinel Syndromic STD Surveillance ** Information obtained from the Microbiological Surveillance, Johannesburg

Prevention of infection
Avoid risk Factors Preventive measures

 Used balanced diet  Avoid prolonged antibiotic use  Follow health seeking behaviours  Keep vagina healthy Avoid self medication

 Wash vulva with your hand  After toilet wipe from front to back  Wear cotton undergarments  (Avoid local sprays  Dont let swimming suit dry on you

Diagnosis
Microscopic examination of vagina Whiff test Culture and sensitivity Pap smear Others

Ongoing Developments: Syphilis

Ongoing Developments: Gonorrhoea/Chlamydia

Ongoing Developments: Trichomonas

VAGINAL DISCHARGE MANAGRMENT

Improve Patient Care
Effective Treatment Services

Improve diagnostic skills

Pin point Diagnosis

History & examination Antimicrobial Medicine Antibacterial medicine Vaginal condition Herbal Risk factors

Lab Investigations

Allopathic

Timeliness

Complete

Less side-effect

Action-oriented

Patient Education

education about vaginal infections Discuss methods of prevention

About the disease and how to prevent reinfection

Decreased Morbidity Surveillance

Good prognosis