nonspecific vulvitis
Introduction
Introduction to non-specific vulvitis The mucosal inflammation of women's vulva in the presence of general bacteria (such as Staphylococcus, Escherichia coli, Streptococcus), and feces, vaginal secretions or other physical and chemical factors, called non-specific vulvitis. Vulvitis is caused by vaginal, cervical inflammatory vaginal discharge and cervical cancer secretions, menstrual blood or postpartum lochia and stool, long-term stimulation of urine. Generally, inflammation is limited to the inner and outer sides of the labia minora. In severe cases, the entire genital area can be inflamed, swollen and congested. In severe cases, it is eroded and forms superficial ulcers. It has a burning sensation, itching, and pain after scratching. These symptoms are often exacerbated during urination. When the course of disease is long, the skin is thickened, rough, chapped, and itchy. Usually pay attention to keep the vulva part clean and dry, and the feminine care solution with delicate and weak acid formula is suitable for daily cleaning and maintenance. Especially during menstruation, pay more attention to this. Do not wear chemical underwear and jeans. With vaginitis, cervicitis should be cured in time, etc., have the effect of preventing non-specific vulvitis. basic knowledge The proportion of sickness: 0.01% Susceptible people: women Mode of infection: non-infectious Complications: urethritis
Cause
Cause of non-specific vulvitis
Aerobic infection (40%):
Under normal circumstances, aerobic bacteria and anaerobic bacteria colonize the vagina, forming a normal vaginal flora. Aerobic bacteria include: coryneform bacteria, non-hemolytic streptococcus, enterococci, and Staphylococcus epidermidis. The vagina forms a balanced ecology with these flora, and the vaginal environment affects the flora, which also affects the genital environment. Lactobacillus in the normal vagina predominates and plays a key role in maintaining the normal flora of the vagina. The vulva and vagina are the only way to have sexual intercourse, childbirth and various intrauterine operations, and are susceptible to injury and infection from various external pathogens.
Anaerobic infection (35%):
Facultative anaerobic bacteria include Lactobacillus, Gardnerella and Escherichia coli. Anaerobic bacteria include sputum bacillus, digestive streptococci, Bacteroides, Fusobacterium, and C. mobilis. Although the intravaginal flora is a normal flora, when a large number of antibiotics, changes in hormones in the body or various factors cause the body's immunity to decline, the ecological balance between the vagina and the flora is broken, and conditional pathogens can also be formed.
Other (15%):
In addition, there are mycoplasma and Candida. Although there are genital and vaginal defense mechanisms, because the vulva is adjacent to the urethra, it is adjacent to the anus and is susceptible to contamination.
Prevention
Non-specific vulvitis prevention
Many women suffer from vaginitis, but if we pay more attention to the details of life, it may be possible to stop vulvovaginitis.
1. Develop healthy living habits: adequate sleep, regular diet, eat more fruits and vegetables, exercise properly, relieve stress and tension.
2, good health habits: pay more attention when using public facilities, usually wear loose cotton underwear, try not to use sanitary napkins and pads, clean the vulva daily, feminine care solution suitable for daily cleaning and maintenance. But wash the vagina as little as possible.
Complication
Non-specific vulvitis complications Complications urethritis
Non-specific vulvitis can be complicated by vaginal ulcers, urethritis and the like.
Symptom
Non-specific vulvitis symptoms Common symptoms Severe pain, sexual intercourse, pain, urination, pain, fever, and chills when urinating...
Non-specific vulvitis infections often start from the bottom of a hair follicle and gradually invade many fat columns in the vicinity. If they expand to the periphery and invade multiple hair follicles, they will form multiple pups. The common cockroach is slightly raised, purple-red, and the boundary is unclear. There are a number of pus at the center. After the rupture, it is honeycomb-shaped. After the central part is necrotic and dissolved, it forms a crater-like collapse, which contains a lot of pus and necrotic tissue. At this time, it is the various pathogens that are confronted with our body, manifested as genital edema, severe pain, swollen lymph nodes, systemic fever, chills, body temperature at around 38.5 °C, and increased white blood cell count.
If it is acute non-specific vulvitis, then its symptoms are that the patient feels genital discomfort first, followed by itching and pain, or burning sensation, and there may be varying degrees of skin and mucous membranes in the vulva (including large and small labia, clitoris). The swelling is congested. Chronic non-specific vulvar symptoms mainly manifest as genital itching, thickening of the skin, rough, chapped, and may also be accompanied by dysuria or dyspareunia.
Examine
Non-specific vulvitis examination
Regular routine, urine sugar, vaginal gynecological routine examination. Gynecological routine examinations include: gynecological double examination, electronic colposcopy, gynecological ultrasound, vaginal B-ultrasound. Gynecological ultrasonography is usually B-ultrasound or ultrasound, mainly to check the health of the uterus, ovaries, pelvis and accessories. Electronic colposcopy is a male gynecological clinical diagnostic instrument. It is suitable for the diagnosis of various cervical diseases and genital diseases (sexual diseases). It can magnify the observed images by 10 to 60 times and find tiny lesions that cannot be found by the naked eye.
Diagnosis
Non-specific vulvitis diagnosis and identification
The diagnosis of non-specific vulvitis is not difficult, but laboratory tests such as vaginal secretions, urine sugar, and stool eggs are required to exclude Candida albicans, Trichomonas vaginalis, Neisseria gonorrhoeae infection, and diabetes. , mites infection, etc. And should pay attention to the differentiation of other lesions in the vulva, such as vulvar white syndrome, vulvar white lesions.
Inspection diagnosis
Non-specific vulvitis is often caused by pathogenic bacteria such as Staphylococcus, Escherichia coli, and Streptococcus. The veterinary examination, especially the vaginal discharge smear microscopy and bacterial culture is conducive to the diagnosis of the disease. Clinically, simple vulvitis is rare, and various forms of vaginitis are combined. The test and diagnosis method is also applicable to the diagnosis of vulvitis and vaginitis.
General inspection project
Stimulitis can be caused by stimulation of feces, diabetes, and the like. Therefore, through the examination of general inspection and diagnosis items such as urine sugar and stool routine, the cause of vulvitis can be understood or excluded.
1. Stool routine to find eggs.
(1) Inspection method: pick fresh feces and suspend it on a clean glass slide with 1 drop of normal saline to make a thin film. Find eggs under the microscope
(2) Diagnostic significance and evaluation: Excluding the vulvitis induced by parasitic infections such as aphids, infants and young children are more common.
2. Urine sugar check.
(1) Inspection method:
1) Dry chemical analysis of urine: glucose oxidase method. Under aerobic conditions, glucose is oxidized by glucose oxidase to glucuronic acid and hydrogen peroxide, which releases nascent oxygen (O) under peroxidase catalysis, making o-methylbenzidine (or potassium iodide) different. The color change, its color depth is related to the glucose content in the urine. Most of them use the automatic urine analyzer to interpret the results, and can also judge whether the urine sugar is positive by visual comparison with the standard colorimetric strip.
2) Rapid urine sugar test paper method: more commercial urinary sugar test paper, the measurement method: 1 first urinary sugar test paper immersed in the urine, immediately removed; 2 within 30 seconds and the test paper package on the different urine sugar standard color Compare and judge whether urine sugar is positive.
(2) Clinical diagnosis and evaluation: Exclude vulvitis caused by urine stimulation in diabetic patients.
Special inspection project
1. Microscopic examination of vaginal secretions.
(1) vaginal cleanliness check:
1) Examination method: vaginal secretions are smeared with saline, high-power examination, multi-field observation of white blood cells (or pus cells), epithelial cells, vaginal bacillus, bacteria, check the degree of vaginal cleansing, and check vaginal secretion There are no worms or fungi in the body.
2) Judgment of results: The vaginal cleanliness classification is shown in the table below
3) Significance and evaluation of clinical diagnosis: vaginal cleanliness is normal to I to II degrees, and most of III to IV degrees are vaginitis. Such as smear found in the pathogens such as Candida, Trichomonas, for specific vaginitis; such as a single cleanliness abnormality, often prompted for non-specific vaginitis.
(2) vaginal discharge smear check pathogen:
1) Inspection method: 1 wet film method: take vaginal secretions on the glass slide, add 1 drop of physiological saline to mix, cover the coverslip, check the pathogens such as bacteria, candida, trichomoniasis under high magnification; 2 staining method: After vaginal secretion smear Gram staining, pathogens such as bacteria, Candida, and trichomoniasis are examined under oil microscope.
2) Clinical diagnosis and evaluation: 1 Non-specific vaginitis patients can find non-specific pyogenic bacteria in the vaginal secretions, but no pathogens such as Candida, Trichomonas; 2 vaginal secretion smear examination method is fast and simple, is The main auxiliary diagnostic method for non-specific vaginitis.
2. Vaginal secretion bacterial culture.
(1) Inspection method:
1) Separation, culture and identification of fine sputum: use a sterile swab to take the vaginal or cervical canal 1 to 2 cm secretion partition line to inoculate the blood agar plate, and incubate at 35 ° C for 18-24 hours to observe bacterial growth. In the case of a single bacterium, the identification test is directly carried out. For example, two or more bacteria are isolated and purified, and then the strain is determined by systematic biochemical identification.
2) Pathogenicity drug susceptibility test: The sensitivity of pathogenic bacteria to clinically used antibacterial drugs is detected by disc diffusion method or dilution method. According to CLSI (CIinical and Laboratory Standards Institute, formerly known as NCCLS), the results are judged by S ( Sensitive), I (moderately sensitive), and R (resistance) results are reported clinically, and the dilution method measures the MIC (minimum inhibitory concentration) value.
(2) Significance and evaluation of clinical diagnosis:
1) Non-specific vaginitis patients with vaginal secretions can usually be isolated and cultured to Staphylococcus, Escherichia coli, Streptococcus and other purulent bacteria.
2) The results of pathogenic bacteria susceptibility test can guide the clinical selection of antibacterial drugs.
