Caused by mycobacterial infection, it is second only to trichomonas vaginitis in terms of incidence. Candidiasis is most often seen in young girls, pregnant women, diabetic patients, and patients who have been treated with higher doses of estrogen after menopause. What causes mycotic vaginitis?
There are many species of mycobacteria (Fungus). The most common species in humans is Candida albicans. Vaginal infections are caused by Candida albicans in 80-90% of cases, while the rest are Candida spp. and Candida globosa (Tomlopsis), so mycosis is actually Candida vaginitis or vaginal candidiasis. Candida albicans is ovoid and consists of budding spores and cells that germinate and elongate to form pseudomycorrhizae pseudomycorrhizae are connected to spores in a branched or chain-like manner. Candida is usually a kind of decaying matter parasitic bacteria, which can live in the normal human skin mucous membrane, digestive tract or other organs, often in the vagina and asymptomatic leucorrhea in non-pregnant women, about 10%, about 30% of pregnant women have this bacteria in the vagina when the vaginal glycogen increases, acidity increases, or in the case of reduced body resistance can become the cause of the disease, long-term application of broad-spectrum Long-term application of broad-spectrum antibiotics and adrenocorticotropic hormones can increase mycobacterial infections because these two drugs can lead to dysbiosis in the organism, changing the interrelationship between microorganisms in the vagina and reducing the ability to fight infection. During pregnancy, the glycogen content of vaginal epithelial cells increases, the acidity of the vagina increases and the renal sugar threshold of pregnant women decreases, often with nutritional diabetes, and the sugar content in the urine increases and promotes the growth and reproduction of Candida albicans.
What are the manifestations of mycosis fungoides and how is it diagnosed?
Clinical manifestations.
The most common symptoms of Candida infection are leucorrhoea, burning and itching of the vulva and vagina, exogenous difficulty in urination, and map-like erythema of the vulva (mycosis or Candida vulvovaginitis). Typically, the leucorrhoea is curd-like or lumpy, and the vaginal mucosa is highly erythematous, with white thrush-like patches that can be easily peeled off and under which is the erosive base of the damaged mucosa or a shallow ulcer. In severe cases, petechiae may remain. The leucorrhoea does not always have these typical features, but can range from aqueous to curd-like leucorrhoea. Some of them are entirely thin, clear plasma exudate, often containing white flakes. The symptoms of itching are particularly severe in mycosis vaginalis during pregnancy, and even restlessness and pain, as well as frequent urination and painful intercourse. In addition, about 10% of women and 30% of pregnant women are carriers of mycobacteria without any clinical manifestations.
Diagnosis.
The diagnosis of mycosis based on typical clinical manifestations and visual examination of vaginal excretions is usually not difficult. However, in atypical cases, vaginal discharge examination is necessary to confirm the diagnosis in those suspected of carrying mycobacteria, or to understand the effect of treatment. The vaginal discharge can be taken directly on a slide, add a small drop of isotonic sodium chloride solution or 10%-20% potassium hydroxide solution and coverslip, microscopic examination by microheating, red and white blood cells and epithelial cells immediately dissolve, while the mycobacteria are shown in the form of thread-like fibers or mycelia (mycelia), and there are microspores or molecular spores (conidia) attached but this method is less reliable (60%). If a smear of vaginal secretion is taken and stained with Gram stain, groups of Gram-positive ovoid spores can be found microscopically or pseudomycorrhizal filaments can be seen attached to the germinating cells in chains or branches, which can be easily identified and the reliability can be increased to 80% The most reliable method is to perform mycobacterial culture. In addition, it is important to pay attention to the associated causative factors such as a history of high-dose steroids or broad-spectrum antibiotics, and urine glucose and blood sugar tests in diabetic patients.
What tests should be done for mycosis vaginalis?
Severe and persistent vulvovaginal itching The first thing to consider is whether the mycobacterial infection can be diagnosed by direct smear examination of local secretions and culture. It is called pseudomycorrhiza.
What diseases can be easily confused with mycosis fungoides?
It must be distinguished from trichomoniasis, which is not difficult. If a drop of saline is added to the slide and a small amount of secretion is mixed in for microscopic examination, the diagnosis of trichomoniasis can be confirmed by the presence of Trichomonas viridans in a waveform motion. If the room humidity is too low, the activity of trichomonas is also reduced. If necessary, culture can increase the positive detection rate.
What diseases can be complicated by mycosis fungoides?
Cervical erosion Urethritis, etc.
How should mycosis fungoides be treated?
Wash the vulva or take a sitz bath with 1:5000 potassium permanganate solution and apply 2% gentian violet solution locally.
In recent years, the application of mycoplasma (nystatin) is effective
Usage: 100,000U vaginal suppository once in the morning and once in the evening, inserted deep into the vagina for 5 days. Wash the vulva, local application of mycobacterium ointment (100,000 U / g) 2 to 3 times / d After treatment, in order to promote the regeneration of vaginal epithelium, can apply a small amount of estrogen (has enestrogen 0.25 ~ 0.5 mg / day, 3 to 5 days) recurrent cases should be considered gastrointestinal bacteria, can be added at the same time mycobacterium 500,000 U / time, 4 times a day
The recurrence is mostly due to insufficient dose of medication, incomplete treatment, or abstinence during treatment is not strictly enforced; or men are not treated In addition, in recent years, the application of mycicidal agents such as ketoconazole, triclopirox Clotrimazole are effective, detailed mycotic vaginitis.
How should mycotic vaginitis be prevented?
Precautions.
1, during the treatment should pay attention to the couple at the same time to avoid cross-infection, prohibit sexual life.
The first thing you need to do is to take oral medication in combination with local medication for those who are prone to relapse.
3. Do not wear tight underwear and do not use unclean douching equipment.