The causative organism is Candida albicans.
This bacteria is a conditional pathogen, about 10% of non-pregnant women and 30% of pregnant women have this bacteria in the vagina, and does not cause symptoms, when the vagina glycogen increases, acidity increases, local cellular immunity decreases, suitable for the reproduction of Candida, causing inflammation, so it is mostly found in pregnant women, diabetic patients and those who receive a lot of estrogen treatment, long-term application of antibiotics, corticosteroids or immunodeficiency syndrome, wearing tight chemical fiber underwear, and wearing tight underwear. Obesity can increase the local temperature and humidity of the perineum, which also makes it easy for Candida to multiply and cause infection.
Transmission: Candida parasites in the vagina, oral cavity and intestinal tract, Candida in these three parts of the body can infect each other, and when the local environmental conditions are suitable, it is easy to develop, in addition to direct transmission through sexual intercourse or indirect transmission through contact with infected clothing.
Symptoms: The main manifestations are itching and burning pain in the vulva, in severe cases, sitting and lying down, and also accompanied by frequent urination, painful urination and painful intercourse, increased leucorrhea in the acute stage, the leucorrhea is characterized by white thick curd or beanbag-like. Examination shows vulvar scratches, white membranous material attached to the inner labia minora and vaginal mucosa, which is removed to reveal the red and swollen mucosal surface, and in the acute stage, erosions and superficial ulcers may also be seen.
Diagnosis: The diagnosis can be confirmed by finding Candida albicans spores and pseudomycorrhizae in the discharge.
Treatment: Eliminate the causative factors: base on diabetes should be actively treated, timely discontinuation of broad-spectrum antibiotics, estrogen, corticosteroids, diligent change of underwear, used underwear, basin and towels should be boiling water scalding ear Christine wash.
Topical medication: 2% Suda water rinse vaginal vulva, dacrynic pessary 1 (or clotrimazole pessary 1 or mycophenolate dish) vaginal drug, and used for 7 days as a course of treatment. If the base is accompanied by vulvar itching, the vulva can be coated with mycobacterium or dacrynic acid cream at the same time.
Systemic medication: Itraconazole 200mg per dose orally once daily for 3-5 days; Fluconazole 150mg in a single dose.
Treatment of recurrent cases: It is easy to recur before menstruation. The causes of recurrent cases should be examined, such as the presence of diabetes, application of antibiotics, estrogen or steroid hormones, wearing tight fitting chemical fiber underwear, stimulation by local medication, etc., to eliminate the cause of the disease. Sexual partners should be examined at the same time and preventive medication should be administered. Continuous use for 3-6 months, even a year for stubborn cases.
Trichomonas vaginalis
Trichomonas, also known as “trichomonas”, does not like oxygen and is easily parasitized in the vagina and intestines. Once the vaginal environment is suitable, it multiplies and causes inflammation. Trichomonas is contracted through infection. It is usually transmitted through male-to-male sexual intercourse. Some women are infected indirectly, such as through contact with contaminated bath tubs, towels, toilets or swimming pools. Trichomonas can also be contracted through close contact during life.
The main symptom of trichomoniasis is increased leucorrhea, which is grayish yellow, purulent and foamy, with a fishy odor. Most patients also have itching of the vulva, burning sensation in the vulva and vaginal opening, pain in the vaginal opening during sexual intercourse, and in a few patients, frequent and painful urination. Episodes of the disease can be cyclical, often developing or worsening after the menstrual period. Treatment must also be given to sexual partners at the same time, with persistent treatment follow-up for more than three months.
Bacterial vaginitis
Among women of childbearing age, Candida vaginitis is the most common cause of increased leukorrhea. However, some patients have had multiple tests for trichomonas and candida, or sometimes trichomonas can be detected, but anti-titre treatment does not work. Most of these women have been found to have bacterial vaginitis.
Bacterial vaginitis is the most common vaginal infection in women of childbearing age.
It accounts for 40-50% of vulvar and vaginal infections. The disease has had many names, such as nonspecific vaginitis (mycoplasma and chlamydia infections), Haemophilus vaginitis, and colorectal anaerobic vaginitis. Until recently, the name bacterial vaginosis was used consistently. The term “bacterial” refers to the presence of a large number of anaerobic and aerobic bacteria, mainly anaerobic bacteria; the term “vaginosis” refers to the fact that the symptoms are mainly increased leucorrhea, local inflammation is not obvious, and most patients have no uncomfortable symptoms. It is characterized by a change in the ecological environment of the vagina, with a large number of pathogenic anaerobic bacteria (the specific bacteria that cause bacterial vaginitis are still uncertain) replacing the normal lactobacilli, hence the name bacterial vaginosis. The age of prevalence of the disease is 15-44 years. According to domestic reports, the prevalence of bacterial vaginosis is 10-18,92% in healthy women and 36,73% in women with chaotic sexual relationships. It can also cause recurrent urinary tract infections and even promote the development of cervical cancer. The harm to pregnant women is even greater, as it can increase complications such as premature rupture of fetal membranes, amniotic fluid contamination, premature birth and infections during and after delivery, threatening the health of the mother and child. In addition, it can be spread between both sexes through sexual intercourse, so it is also one of the sexually transmitted diseases. In addition to sexual transmission, it can also be widely spread through vaginal douching, gynecological examinations, toilet seats, towels, underwear and public objects. Therefore, it is important to develop good personal hygiene habits and strengthen the concept of public hygiene.
Vaginitis in the elderly
Geriatric vaginitis, also known as atrophic vaginitis, is a non-specific vaginitis. It occurs mostly in postmenopausal women, but can also occur in women after bilateral oophorectomy or during lactation.
Based on age of onset, history, and local examination, the vulva is flushed and moist, and the vaginal wall is congested with scattered bleeding spots, most evident in the posterior fornix and cervix. Ulcers may be formed after the vaginal mucosa is exfoliated. It is usually not difficult to diagnose. When chronic inflammation develops, two outcomes can occur: one is fibrosis of the submucosal connective tissue, loss of elasticity of the vagina, and eventually narrowing and scarring of the vagina; the other is adhesion of the vaginal wall to form vaginal atresia, or even pus accumulation above the atresia. This is a rare but serious condition.
The principle of treatment for senile vaginitis is to strengthen the vaginal mucosa.
It is to strengthen the resistance of the vaginal mucosa and to inhibit the growth and reproduction of bacteria. For systemic medication, ethylene estradiol 0,25 to 0,5 mg can be given orally once a day for 7 days. It sometimes causes withdrawal uterine bleeding after taking the drug. Topical medication is used to improve vaginal pH by douching with 1% lactic acid or 1:5000 potassium permanganate. Vaginal sitting medication can be put every night, ethenol tablets 0,25-0,5mg, into the vagina once a day for 7 days. If necessary, local antibiotic powder or ointment can be sprinkled and applied.
The main cause is due to the decline of ovarian function.
Low estrogen level or lack of estrogen in the body, reduced glycogen of vaginal epithelial cells, alkaline pH in the vagina, and reduced ability to kill pathogenic bacteria. Atrophy of the vaginal mucosa, thin epithelium and lack of blood flow make the vagina less resistant to bacterial invasion and reproduction and cause inflammatory lesions. In addition, poor personal hygiene and nutritional deficiencies, especially group B vitamin deficiencies, may be associated with the development of the disease.
Clinical manifestations.
The main symptoms are increased leucorrhea, yellowish watery or purulent, with a foul odor. When the infection is severe, there may be spotting vaginal bleeding, and there is downward pain and vaginal burning sensation. If the mucous membrane around the vestibule and urethra is involved, frequent and painful urination often occurs. To differentiate from atopic vaginitis, vaginal secretions should be taken for examination to exclude pathogens such as trichomonas and mycobacteria. Bloody leucorrhea should be differentiated from malignant tumor of the uterus. During gynecological examination, attention should be paid to the size and shape of the uterus, the source of bleeding and vaginal cytology, and if necessary, cervical or endometrial biopsy, etc.