bacterial vaginosis
Introduction
Introduction to bacterial vaginitis Bacterial vaginitis (BV) is a mixed infection of vaginal Gardnerella and some oxygen-oxidizing bacteria, resulting in imbalance of vaginal micro-ecological balance, resulting in increased vaginal discharge, white sputum odor and genital itching and burning. Syndrome. Can be divided into Haemophilus vaginitis, Corynebacterium vaginitis, hypoxic vaginal disease, Gardnerella vaginitis. The disease can also be transmitted through sexual contact, and the incidence is higher in people with sexually disturbed relationships. A smear of the secretion can detect a large number of pus and find the pathogen. This disease can often be combined with other vaginal sexually transmitted diseases, so its clinical manifestations may be affected by comorbidities, such as when combined with gonococcal infection, vaginal discharge can be characterized by obvious purulent traits, and urinary pain can occur. Urinary tract irritation such as dysuria; combined with trichomoniasis, foamy vaginal secretions may occur, and itching is exacerbated, showing itching; when combined with Candida infection, vaginal secretions may appear as curd or bean curd. basic knowledge The proportion of illness: 0.13% Susceptible people: women Mode of transmission: sexual transmission Complications: pelvic inflammatory disease, cervicitis
Cause
Cause of bacterial vaginitis
Indirect contact infection (20%):
It is a route of transmission of bacterial vaginitis. Toilets, bathtubs, bath chairs, towels, and unclean toilet paper that are in contact with a patient infected with a bacterial patient can cause spread. Try to avoid using public goods.
Sexual transmission (35%):
Sexual transmission is one of the causes of this. At least 10% of women with symptoms of the disease have bacterial urethritis, and reasonable treatment should be given to prevent cross-infection. Therefore, we must do a good job of defense and cleanse ourselves.
Take a lot of antibiotics (10%):
Some women buy medicines themselves from pharmacies. The large amount of antibiotics changes the microenvironment of the vagina. Pathogenic bacterial pathogens may multiply, eventually leading to local bacterial vaginosis.
Excessive hygiene (10%):
Daily use of female care solution can be, but some women often use medicated lotion to maintain the vagina in order to maintain hygiene, which is easy to destroy the acid and alkali environment of the vagina, but it is easy to get infected with bacterial vaginitis.
Prevention
Bacterial vaginitis prevention
[Prevention and nursed back]
1. Keep the vulva clean.
2. Sex life is prohibited during treatment.
3, the diet should be light, avoid spicy and greasy.
Complication
Bacterial vaginitis complications Complications Pelvic inflammatory cervicitis
Common complications and gynecological cervicitis, pelvic inflammatory disease occur simultaneously, often with trichomonas vaginitis, it is reported that 86% of women with positive culture of trichomoniasis combined with this disease, in addition to bacterial vaginal disease during pregnancy Can 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
Bacterial vaginitis symptoms common symptoms leucorrhea abnormal lower body odor purulent secretions urinary pain leucorrhea odor vaginal odor lower abdominal pain vaginal discharge yellow-white with milk white sexual intercourse difficulties
The typical clinical symptoms of this disease are markedly increased vaginal abnormal secretions, which are thin homogeneous or thin paste, grayish white, grayish yellow or milky yellow, with special fishy smell, due to alkaline prostatic fluid can cause amines Released, so the performance of sexual intercourse or sexual intercourse after the odor increased, menstrual period vaginal PH value increased, so the odor after menstruation or menstruation can also be aggravated, the patient's vulva has discomfort, including varying degrees of genital itching, generally no obvious Temporality, but the itch is more obvious in the state of rest and mood, there are different degrees of burning sensation in some cases, some patients have sexual pain, very few patients have lower abdominal pain, difficulty in sexual intercourse and abnormal urination, vaginal mucosa The epithelium showed no obvious hyperemia at the time of onset.
This disease can often be combined with other vaginal sexually transmitted diseases, so its clinical manifestations may be affected by comorbidities, such as when combined with gonococcal infection, vaginal discharge can be characterized by obvious purulent traits, and urinary pain can occur. Urinary tract irritation such as dysuria; combined with trichomoniasis, foamy vaginal secretions may occur, and itching is exacerbated, showing itching; when combined with Candida infection, vaginal secretions may appear as curd or bean curd.
Examine
Examination of bacterial vaginosis
Laboratory examination is very necessary for the diagnosis of this disease. The increase of leucorrhea alone and no laboratory examination can not diagnose the disease. Laboratory tests include smear, amine test, culture method, biochemical method, fluorescent antibody method, etc. The smear method and the amine test are simple and easy-to-operate laboratory methods that are useful for diagnosis and can be used for culture or fluorescent antibody assays.
(1) Smear microscopy for secretions for smears to find Clue cells, clue cells are epithelial cells with a large number of Gardner bacteria attached to the surface, characterized by rough or fine particles on the surface of epithelial cells. It seems to have been sprinkled with a layer of flour, and the bacteria are Gram-negative bacilli.
(2) Amine test Take a drop of 10% potassium hydroxide solution into the vaginal secretions, you can smell the "fishing sputum"-like ammonia release, because the amount of amine in the secretion is higher, the ammonia smell can be released after the alkali Come.
(3) The culture method should be separated and cultured first, and a colony with a diameter of 0.5 mm, opaque and smooth surface can be seen.
(4) Biochemical method for vaginal secretions for biochemical determination, normal women with high lactate, low succinate, and the opposite value of women in this disease.
(5) Fluorescent antibody staining and microscopy after fluorescent smear.
Diagnosis
Diagnosis and identification of bacterial vaginitis
diagnosis
First, the vaginal secretions are grayish white, very viscous, even like batter, uniform, but not purulent secretions, the amount is uncertain.
Second, the secretion of amines is particularly high, so it is a fishy smell. During sexual intercourse or after activities, the odor is aggravated by the release of amines. The secretion of amines can also be released after adding 10% potassium hydroxide to the secretions.
Third, the pH value in the vaginal secretions increased, the PH range of 5.0-5.5, and the normal person is 4.5-4.7.
4. The clue cells can be detected in the wet smear of vaginal secretions.
Among the above four criteria, more than three can be diagnosed, and the fourth is the necessary diagnostic criteria.
Differential diagnosis
And trichomonas vaginitis, candida vaginitis, senile vaginitis and other identification.
