fungal vaginitis
Introduction
Introduction to fungal vaginitis Mycobacterial vaginitis (monilialormycoticvaginitis) is caused by mold infection, and its incidence is second only to trichomonas vaginitis. Candida vaginitis is more common in young girls, pregnant women, diabetics, and patients who have been treated with larger doses of estrogen after menopause. basic knowledge The proportion of illness: 0.03% Susceptible people: women Mode of transmission: sexual contact spread Complications: cervicitis pelvic inflammatory disease trichomonas vaginitis premature rupture of membranes premature delivery
Cause
Cause of fungal vaginitis
The main causes are: sexual contact, contaminated clothing, sanitary napkins that are not sanitized, toilet paper and pads.
There are many kinds of fungus (fungus), the most important one in the human body is Candida albicans, 80-90% of vaginal infections are caused by Candida albicans, and the rest are Candida species and Tomlopsis, so moldy. Vaginitis is actually candida vaginitis or vaginal candidiasis (vagmal candidiansis), Candida albicans is oval, germinated and germinated to form pseudohyphae, pseudohyphae and spores connected branches or chains Candida is usually a spoilage parasitic organism that can live in normal human skin, mucous membranes, digestive tract or other organs, often present in the vagina and asymptomatic, among non-pregnant women with increased vaginal discharge, 10%, about 30% of pregnant women have this kind of parasitic in the vagina. When the vaginal glycogen increases, the acidity increases, or the body's resistance is reduced, it can become the cause of the disease. Antibiotics and adrenocortical hormones can greatly increase the number of mold infections, because the above two drugs can lead to dysregulation of the flora in the body, changing the mutual restriction relationship between microorganisms in the vagina, and the ability to resist infection, In addition, vitamin deficiency (multivitamin B), serious infectious diseases, and other wasting diseases can be favorable conditions for Candida albicans reproduction. Increased glycogen content in vaginal epithelial cells during pregnancy, increased vaginal acidity, and kidneys of pregnant women The sugar threshold is lowered, and there is often nutritive diabetes, and the sugar content in the urine is increased to promote the growth and reproduction of Candida albicans.
Prevention
Fungal vaginitis prevention
1. Eliminate the cause of the disease. If you are actively treating diabetes, stop using broad-spectrum antibiotics or estrogens in time.
2. Pay attention to hygiene, change underwear, especially the pants. The changed clothes must be disinfected with the underwear degerming solution to avoid cross infection in public places.
3. Vaginal mold often infects, coexists or interacts with other parts of the mold, such as mold in the mouth and intestines. If necessary, take samples at these locations for mold microscopy or culture. For patients with typical clinical manifestations or mild mold, they should be treated promptly.
4. For patients with refractory or recurrent episodes of fungal vaginitis, sexual transmission is also one of the causes of recurrence. At least 10% of men with symptomatic symptoms of menstrual urethritis should be given reasonable treatment to prevent cross-infection.
5. The direction of wiping after stool should be from front to back to avoid bringing Candida at the anus to the vagina.
6. Pay attention to menstrual hygiene, correct use of disinfected toilet paper, sanitary napkins, wash frequently, change underwear frequently, underwear should be placed in the sun after washing; wash the vulva with ph4 weak acid female care solution before going to bed.
7, to prevent fashion vaginitis. The popular body pants are thin and short, and the breathability is poor, so that bacteria can multiply.
8, to prevent indirect infection of sexually transmitted vaginitis. Pay special attention when swimming, sauna, and bathing.
Complication
Fungal vaginitis complications Complications Cervicitis pelvic inflammatory disease Trichomonas vaginitis Premature rupture of membranes
Common complications and gynecological cervicitis, pelvic inflammatory disease occur at the same time, often with trichomonas vaginitis, it is reported that 86% of women with positive trichomoniasis culture combined with this disease.
In addition, fungal vaginosis during pregnancy can often cause adverse perinatal outcomes such as chorioamnionitis, amniotic fluid infection, premature rupture of membranes, premature delivery and endometrial infection after cesarean section or vaginal delivery.
Symptom
Fungal vaginitis symptoms Common symptoms Itching lower body odor urinary pain Acute vaginal infection vaginal discharge is slag-like urinary frequency leucorrhea increased Candida infection leucorrhea odor leucorrhea scarce
The most common symptoms of Candida infection are leucorrhea, genital and vaginal burning itching, external dysuria, vulva map-like erythema (mycotic or candida vulvovaginitis), typical vaginal discharge is curd or lumpy, The vaginal mucosa is highly red and swollen. It can be seen that the white thrush-like plaque is attached and easily peeled off. The underlying is the erosion base of the damaged mucous membrane, or the shallow ulcer is formed. In severe cases, the ecchymosis may remain, but the leucorrhea does not have the above typical characteristics. The water sample can appear until the curd-like vaginal discharge, if any are some thin and clear serous exudate, which often contains white flakes. The symptoms of fungal vaginitis during pregnancy are especially serious, even lying down. Restless, painful, and can also have frequent urination, dysuria and dyspareunia. In addition, about 10% of women and 30% of pregnant women are mold carriers, but there is no clinical manifestation.
Examine
Examination of fungal vaginitis
Severe and intractable genital itching, first of all should consider whether mold infection, can be directly diagnosed by local smear examination and culture, microscopic examination of fungal mycelium branches and spores, Candida albicans is oval, Gram staining is negative, but the staining is often uneven, about 3 ~ 5m (larger than the staphylococcus), often produce long buds without falling off (buds), so that the shape is like hyphae and not a hyphae, so it is called Fake hyphae.
Diagnosis
Diagnosis and identification of fungal vaginitis
According to the typical clinical manifestations and visual inspection of vaginal excretion, it is usually not difficult to diagnose fungal vaginitis. However, in atypical cases, in order to confirm the diagnosis, those suspected of having mold, or understanding the therapeutic effect, must be treated as vaginal secretions. Check, you can directly take the vaginal secretions on the slide, add a small drop of isotonic sodium chloride solution or 10% ~ 20% potassium hydroxide solution, add a cover glass, micro-heat microscopy, red, white blood cells and epithelial cells dissolve immediately And the mold is displayed in the form of wire-like fibers or mycelia, and has micro-buds or molecular spores attached, but this method is less reliable (60%), such as vaginal secretions After Gram staining, the ovarian spores can be found in the group of Gram-positive dense stains, or the pseudohyphae can be connected to the budding cells in a chain or branch shape, which is easy to identify and the reliability can be improved to 80. %, the most reliable method is to carry out mold cultivation. In addition, it is necessary to pay attention to the related incentives, such as the application of high-dose steroid hormone or broad-spectrum antibiotic history, and diabetes patients need to do urine sugar and blood sugar check.
It must be differentiated from trichomonas vaginitis. It is not difficult to add a drop of normal saline to the slide. After mixing a little secretion, a microscopic examination can be performed. If a trichomoniasis can be found, it can be diagnosed as trichomoniasis. Vaginitis, when the room is too low, the activity of trichomonias is also reduced. The salt water can be warmed up and then checked. If necessary, the positive detection rate can be improved.
