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Infectious disease AND Vaginitis [keywords]
- [Vaginal disbacteriosis--social and sexual risk factors]. [English Abstract, Journal Article, Review]
- Akush Ginekol (Sofiia) 2013; 52(2):17-25.
The vaginal microbe equilibrium could be impaired by different agents. Many of the risk factors can change the preventive mechanisms of the vagina and can lead to inflammation and disease. We even do not suppose about the role of most of them in impairing of vaginal microbe equilibrium. The exact understanding of those risk factors and mechanisms by which they disturb the vaginal microbe balance could reduce female morbidity of vaginal disbacteriosis and vaginal inflammations. The aim of this literature synopsis is to review some of the most frequent risk factors for vaginal disbacteriosis and about how they change vaginal micro-flora with dominant lactobacillus within it. The most informative and detailed articles on the theme which were found in the resent literature as well as in Medline for the period between 1990 and 2012 were selected. The risk agents for vaginal disbacteriosis are: endogenetic, social, sexual, infectious and iatrogenic. The social and sexual factors are the most frequent in our daily round. The intensity and the kind of sexual life, smoking, homosexual connections, vaginal douching and contraception methods are included in them. All these factors depend on us. Thus we hope that through their popularization and discussion will help to prevent the females' health.
- Lamisil versus clotrimazole in the treatment of vulvovaginal candidiasis. [Journal Article]
- Iran J Microbiol 2013 Mar; 5(1):86-90.
Vaginal candidiasis is a common disease in women during their lifetime and occurs in diabetes patients, during pregnancy and oral contraceptives users. Although several antifungals are routinely used for treatment; however, vaginal candidiasis is a challenge for patients and gynecologists. The aim of the present study was to evaluate terbinafine (Lamisil) on Candida vaginitis versus clotrimazole.In the present study women suspected to have vulvovaginal candidiasis were sampled and disease confirmed using direct smear and culture examination from vaginal discharge. Then, patients were randomly divided into two groups, the first group (32 cases) was treated with clotrimazole and the next (25 cases) with Lamisil. All patients were followed-up to three weeks of treatment and therapeutic effects of both antifungal were compared.Our results shows that 12 (37.5%) patients were completely treated with clotrimazole during two weeks and, 6(18.8%) patients did not respond to drugs and were refereed for fluconazole therapy. Fourteen (43.8%) patients showed moderate response and clotrimazole therapy was extended for one more week. When Lamisil was administrated, 19 (76.0%) patients were completely treated with Lamisil in two weeks, and 1 (4.0%) of the patients did not respond to the drug and was refereed for fluconazole therapy. Five (20.0%) of our patients showed moderate response and Lamisil therapy was extended for one more week.Our results show that vaginal cream, 1% Lamisil, could be suggested as a first-line treatment in vulvovaginal candidiasis.
- Does bacterial vaginosis cause pelvic inflammatory disease? [Journal Article, Review]
- Sex Transm Dis 2013 Feb; 40(2):117-22.
Pelvic inflammatory disease (PID), the infection and inflammation of the female genital tract, results in serious reproductive morbidity including infertility and ectopic pregnancy. Bacterial vaginosis (BV) is a complex alteration of the vaginal flora that has been implicated in PID. The role of BV in the etiology and pathogenesis of PID has not been studied extensively. Our objective was to extensively review data related to the relationship between BV and PID (n = 19 studies). Several studies found a link between BV and cervicitis, endometritis, and salpingitis. Furthermore, it seems that some BV-associated organisms are associated with PID, whereas others are not. However, studies demonstrating an independent association between BV-associated organisms and PID are sparse. In addition, a causal association between BV and PID has not been established. Prospective studies are needed to further delineate the role of BV in PID, with particular focus on individual BV-associated organisms.
- Trichomonas vaginalis vaginitis in obstetrics and gynecology practice: new concepts and controversies. [Journal Article, Research Support, Non-U.S. Gov't, Review]
- Obstet Gynecol Surv 2013 Jan; 68(1):43-50.
Trichomonas vaginalis (TV) is the most common curable sexually transmitted infection worldwide. Annually, 7.4 million new infections are estimated in the United States, which is greater than combined new cases of Chlamydia, gonorrhea, and syphilis. Serious adverse reproductive health outcomes including pregnancy complications, pelvic inflammatory disease, and an increased risk of HIV acquisition have been linked to TV infection. There are several sensitive and specific diagnostic tests available, including a newly approved nucleic acid amplification test (NAAT) that utilizes the same instrumentation platform and clinical sample as Chlamydia and gonorrhea tests. In this article, we review TV pathogenicity, adverse reproductive health outcomes, detection, and treatment followed by clinical scenarios for which TV diagnosis may prove useful in obstetrics and gynecology practice.
- Mycoplasma genitalium incidence, organism load, and treatment failure in a cohort of young Australian women. [Journal Article, Research Support, Non-U.S. Gov't]
- Clin Infect Dis 2013 Apr; 56(8):1094-100.
Mycoplasma genitalium (MG) is an emerging sexually transmitted infection (STI) that is potentially associated with reproductive tract sequelae in women. This study aimed to estimate MG incidence and treatment failure and provide estimates of organism load in infection.1110 women aged 16-25 years were recruited from primary care clinics in Australia. Women were tested for MG at baseline, 6 months, and 12 months, and MG organism load was measured by quantitative polymerase chain reaction (PCR). MG-positive cases were screened for MG 23S ribosomal RNA (rRNA) gene point mutations shown to confer azithromycin resistance using high-resolution melt following PCR.MG incidence rate was 1.3 per 100 person-years (n=14; 95% confidence interval [CI], .8-2.3); women reporting 3 or more sex partners in the last 12 months had an increased rate of incident infection (rate ratio [RR], 5.1; 95% CI, 1.3-19.6]). There were 3 cases of MG reinfection (0.8 per 100 person-years [95% CI, .1-.9]. Organism load was higher for prevalent than incident infection (P=.04). There were 3 cases of treatment failure (9.4% [95% CI, 2.0-25.0]); organism load was higher in cases with treatment failure than in successfully treated cases (P<.01). An MG 23S rRNA mutation was detected in 5 cases (3 cases of treatment failure and 2 successfully treated).Although MG incidence was relatively low, testing should be recommended for women considered to be at increased risk based on sexual history. Our results also suggest that organism load might be important in azithromycin treatment failure.
- [Generalized cutaneous candidiasis in newborn at term]. [Case Reports, English Abstract, Journal Article]
- Biomedica 2012 Jun; 32(2):170-3.
Cutaneous candidiasis is a disease that affects children as well as adults. The presentation may be localized or systemic, and with multiple etiological agents. The most prevalent infecting species in children differs from that of the adult.A case is presented where a congenital cutaneous candidiasis was transmitted to the child during birth.A full term newborn was exposed to a subclinical vaginal candidiasis infection, and 24 hr after birth, developed congenital cutaneous candidiasis. The etiological agent was Candida albicans, and was associated with sepsis and respiratory distress. Blood cultures, cutaneous biopsy of vesicular lesions, blood tests and lumbar puncture were performed.Biochemistry and blood count showed a CRP of 5.7 mg/dl, leukocytosis with left shift and mild anemia. After 24 hr, the blood analyses showed an increase in a CRP (7.8 mg/dl) and increased progressively for three days; consequently, a lumbar puncture was performed. Blood culture was positive for Staphylococcus aureus. Cutaneous biopsy confirmed the cutaneous candidiasis.The early diagnosis is essential to prevent complications derived by the Candida albicans in newborns.
- [Detection of the interferon deficiency in inflammatory gynecological diseases and its correction with interferon inducers]. [English Abstract, Journal Article]
- Georgian Med News 2012 Nov; (212):24-32.
Interferons deficiency has a negative influence on the development of infection and inflammation in general. The use in the complex of anti-inflammatory therapy of interferon inducers (Meglumine acridоnacetate, Tilorone), combining antiviral, immunomodulatory, interferon correction effects with etiopathogenic action leads to the correction of the interferon system defects and eliminate etiological infectious agents, that is confirmed by laboratory data and clinical efficacy.
- [Gonococcal vulvovaginitis in prepubertal girls: sexual abuse or accidental transmission?]. [Case Reports, English Abstract, Journal Article]
- Arch Pediatr 2013 Jan; 20(1):37-40.
Vulvovaginitis is the most frequent gynecologic pathology among prepubertal females. An infectious cause is found in 30% of cases and is highly associated with the presence of vaginal discharge upon examination. Neisseria gonorrhoeae may be one of the causative agents. Since N. gonorrhoeae is a common sexually transmitted disease, sexual abuse should be considered in the pediatric setting. We report the case of a 5-year-old girl with N. gonorrhoeae vulvovaginitis. Her previous history, multiple interviews with the patient and her parents, and clinical examination showed no evidence or signs of sexual abuse. Both parents presented gonorrhea, urethritis for the father and vaginitis for the mother. The discrepancy between pediatric evaluation and the presence of a bacterium associated with sexually transmitted disease led us to consider other means of contamination. Previous studies have shown that other routes of transmission are possible but are often neglected. Hence, contamination can be transmitted by the hands or mostly through passive means (towels, rectal thermometer, etc.). Many epidemics have been noted in group settings with young girls with no evidence of sexual transmission. Therefore, we concluded that this patient's infection was likely an accidental transmission within her family. The acknowledgement of these transmission routes is very important in order to avoid misguided suspicion of sexual abuse and the possible traumatic family and psychosocial consequences.
- Fluconazole-resistant Candida albicans vulvovaginitis. [Journal Article]
- Obstet Gynecol 2012 Dec; 120(6):1407-14.
As a result of high recurrence rates of Candida albicans vaginitis, successful suppressive fluconazole is widely used, and drug resistance is considered rare. We report increased occurrence of secondary fluconazole resistance, analysis of risk factors thereof, and describe management of fluconazole-refractory vaginitis.Patients referred to the Vaginitis Clinic at Wayne State University with clinically refractory fluconazole-resistant (minimum inhibitory concentration [MIC] 2 micrograms/mL or greater) C albicans vaginitis from 2000 to 2010 were enrolled. Patients completed a questionnaire pertaining to demographics, comorbidities, behavioral characteristics, exposure to antimicrobials and antifungals, fluconazole consumption in defined daily doses in the previous 6 months, management received, and outcomes. With patients not located, data were extracted from charts. Susceptibilities to antifungals were determined by broth microdilution.Twenty-five women with fluconazole-resistant recurrent C albicans vaginitis were identified, and 16 returned filled questionnaires. Study cohort consisted mainly of married, insured white women with more than 12 years of formal education and average or above average socioeconomic status. Median fluconazole MIC was 8 micrograms/mL (range 2-128 micrograms/mL). Risk factors for mycologic failure included increased fluconazole consumption (P=.03) with 16 of 25 women exposed to low-dose weekly fluconazole maintenance therapy. All patients were clinically controlled successfully, although treatment was difficult and often prolonged.Fluconazole-resistant C albicans vaginitis was previously considered rare. We report 25 cases over an 11-year period, indicating an emerging problem. All patients had fluconazole consumption in the previous 6 months. Management of fluconazole refractory disease is extremely difficult with limited options, and new therapeutic modalities are needed.
- Opportunistic infections in women with HIV AIDS. [Journal Article, Review]
- Clin Obstet Gynecol 2012 Dec; 55(4):927-37.
Women account for half of the global human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) infections. Heterosexual contact is the leading risk factor in women. Over 50% of patients are significantly immunosuppressed at the time of diagnosis. Women with advanced HIV infection are at a risk for opportunistic infections (OIs). OIs lead to significant morbidity and cost. Some of OIs may impact women more significantly than men, that is, human papillomavirus infection and cervical cancer. OIs during pregnancy can increase the risk of maternal-to-child transmission of HIV and some OIs, such as Hepatitis C. This chapter will review of OIs that are most important in women's health.