Outline On Vaginal Disease

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Vaginal infections
What are vaginal infections?
Vaginal infections are typically due to bacterial, fungal, or parasitic infection of the vagina. These infectious organisms often include Gardnerella vaginalis, Gonorrhea, Chlamydia, Candida, and Trichomonas. Patients usually develop symptoms such as vaginal itching, burning, discharge, malodor, redness, spotting, and occasionally pelvic pain. Some may experience pain during intercourse (dyspareunia).
Vaginal infections often occur in women with risk factors such as a history of sexual transmitted infection, sexual promiscuity, obesity, diabetes, and use of certain medications (eg, antibiotics, corticosteroids). Due to the importance of this condition, it is essential that patients understand
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• What are the symptoms and signs of vaginal infections?
• How are vaginal infections diagnosed?
• How are vaginal infections treated?
What causes vaginal infections?
Vaginal infections are caused by infectious organisms such as bacteria, fungi, or parasites. These microorganisms often include:
• Gardnerella vaginalis – bacteria responsible for bacterial vaginosis
• Gonorrhea & Chlamydia – these frequently coexist and cause cervicitis and pelvic inflammatory disease
• Candida – causes female genital yeast infection
• Trichomonas
Bacterial vaginosis is the most frequent cause of vaginitis in women of reproductive age. Patients with vaginal infection usually develop vaginal irritation and inflammation resulting in itching, burning, discharge, malodor, and occasionally pelvic pain.
Risk factors for vaginal infection include:
• Multiple sexual partners
• History of sexually transmitted infection
• Lack of use of barrier protection such as condoms
• Obesity
• Diabetes mellitus
• HIV/AIDS
• Medications - antibiotics, corticosteroids
How common are vaginal
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These symptoms occur due to inflammation of the vaginal mucosa.
Patients with yeast infection (vulvovaginal candidiasis) typically have a curdy white discharge that appears like cottage cheese. Bacterial vaginosis is associated with a fishy amine odor. Trichomonas classically produces a greenish-yellow purulent discharge.
Patients with pelvic inflammatory disease often have fever, severe pelvic or abdominal pain, and systemic symptoms. Pelvic examination may demonstrate cervical discharge (cervicitis). Individuals tend to have exquisite pain when the doctor manipulates the cervix - chandelier sign.
How are vaginal infections diagnosed?
The diagnosis of vaginal infection is suggested based on symptoms, patient history, and physical examination. Your doctor will typically begin by obtaining a detailed gynecologic, obstetric, and sexual history. This will normally include your last menstrual period and if you are using contraceptives or barrier devices (condoms) during sexual intercourse.
The diagnosis of vaginal infection is typically confirmed with a vaginosis screen. Your doctor will usually obtain vaginal discharge specimens during speculum examination and send them to the laboratory for pH

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