reproductive tract infection
Introduction
Introduction to reproductive tract infections Reproductive tract infections are a common type of disease that affects and harms the health of the general public, especially women. Genital tract infections are a general term for a large number of diseases that cause genital tract infections or genital tract infections (such as AIDS) due to the invasion of multiple pathogenic microorganisms. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of transmission: sexual transmission Complications: acute female genital ulcer
Cause
Causes of reproductive tract infections
Bacterial virus infection (40%)
Women are responsible for the main tasks of pregnancy, childbirth and contraception, increasing the chance of infection. Because the external outlet of the vagina is adjacent to the anus and the urethra, the exposed area of the vaginal mucosa is large. If you do not pay attention to the use of pH4 weakly acidic female care solution, the vulva is prone to vaginal infection. Most women of childbearing age have varying degrees of cervical epithelial cell translocation (cervical erosion), making it easier for pathogens to reach target cells, increasing the chance of infection. The study found that 50%-60% of women often have no obvious clinical manifestations after genital tract infection/sexually transmitted infection, which not only delays the treatment, but also increases the risk of further infection.
Drug factor (20%)
There are various kinds of microorganisms in the vagina. In maintaining the vaginal ecological balance, lactobacilli, estrogen and vaginal pH play an important role. Under physiological conditions, estrogen makes the vaginal epithelial hyperplasia thick and rich in glycogen, vaginal epithelium. The cell breaks down the glycogen into a monosaccharide. Lactobacillus vaginalis converts the monosaccharide into lactic acid, maintains the normal acidic environment of the vagina (pH 4.5, mostly in the range of 3.8 ~ 4.4), and inhibits the growth of other pathogens, which is called vaginal self-purification. Long-term oral administration of antibiotics and hormonal drugs can destroy the normal acidic environment in the vagina and cause genital tract infections.
Social factors (5%)
In addition, affected by economic and traditional cultural concepts, women can not seek medical treatment in time after symptoms of infection, and also increase the chance of infection transmission.
Other factors (30%)
Vaginal washing, sexual life, and surgical procedures can also cause genital infections.
Prevention
Reproductive tract infection prevention
(1) Daily private care should use pH4 weakly acidic female care solution to maintain the self-cleaning function of the vagina.
(2) Be careful, and the more people engage in unprotected sex, the more likely they are to be infected with reproductive infections.
(3) When engaging in vaginal, anal or oral sex, use condoms and spermicides from start to finish. Remember the principle: Every time you engage in sex, you must engage in safer sex.
(4) Pay attention to symptoms at any time. If there are any unusual secretions, wounds, pustules, wounds, lumps, itchy or pain in the penis, vagina or anus, on or around the anus, or if you have sex with someone who believes it may be infected with a reproductive infection. Please go to the doctor for an examination. If you have any questions, it is always a smart thing to do the inspection. At the same time, stop sexual activity first.
(5) If you have symptoms, you should see your doctor promptly, otherwise the infection will worsen and may have been transmitted to another person. Unexplained illnesses are multiple and can threaten the symptoms of life infections. Some symptoms may be like mild infections. Only the doctor can determine what is wrong with the diagnosis. Many hospitals can conduct inspections and inspections in complete secrecy. Except for people who have a sexual relationship should tell him, others will not know that you are infected with a reproductive infection. Check the phone book or ask the city or national health department to see where to do secret testing and treatment.
(6) If sexual activity is active, please do a medical checkup regularly. Since you may get a reproductive infection and never have any symptoms, please do not wait until you notice a problem. Please plan to take at least one or two checks a year to determine that you are not infected. Women should have breast and pelvic examinations every year. Do not flush the vagina, engage in sexual activity or use any vaginal medical procedure before pelvic examination, as this will make it more difficult for doctors to check for vaginal discharge that can show infection. If the test results indicate a infection with a reproductive infection, please inform your partner so that he or she can also receive treatment so that they do not repeat the infection.
(7) Please explain the situation to the doctor confessed. Find a doctor or other health care worker who can feel at ease and then be completely confessed to the person who is checking. Tell the doctor if there are any symptoms, whether it is not only sexual relationship with a person, whether it is engaged in vaginal, anal or oral sex, whether it is injecting drugs, or that it is pregnant. Many of the symptoms of reproductive infections may be mistaken for other diseases, and if you do not provide all the information about your doctor, you may not be able to get the right treatment. Remember: doctors are not going to judge, but to treat, so don't be unwilling to tell the truth. If a doctor really feels embarrassed, then choose another doctor.
Complication
Reproductive tract infection complications Complications
1. ulcers, bleeding;
2. Inflammatory infections in non-genital areas;
3. Cancer: It can be whole body.
Symptom
Symptoms of genital tract infections Common symptoms Frequent urination with urgency and dysuria Turtle head itching Urgency
The most common symptoms of reproductive infection
1 Chlamydia disease - this is a bacterial infection, is currently the most common sexually transmitted disease, but if it is treated early, it can be cured by antibiotics. 75% of female patients and 25% of male patients do not have symptoms. Symptoms: abnormal excretion, pain in the urine, pain in the lower abdomen or pain during intercourse.
Gonorrhea - This is a disease transmitted by bacteria that can invade the human cervix, urethra, rectum, eye or throat and often coexists with chlamydia.
Symptoms: Feeling burning or itching when you urinate, maybe you may not have any symptoms.
Two human papillomaviruses, also known as HPV or genital warts, are among the most common sexually transmitted diseases in the United States. As the name suggests, this is a virus that, once infected, will last a lifetime. Wet sputum may be born in the vulva, in the vagina, on the cervix, in the anus, or even in the throat. Therapies for genital warts include freezing by condensation therapy, treatment with laser therapy, surgical resection or chemotherapy. Although treated, genital warts may recur later, and some of these viruses can cause cervical cancer. Therefore, for women who have already had an HPV, the Pap test should be done at least once a year. Pap tests should be performed several times for susceptible infections.
Symptoms: Wet sputum may be found in the vulva, in the vagina, on the cervix, in the anus, or even in the throat.
3 Genital herpes - or herpes zoster - is transmitted through skin contact. Symptoms begin to manifest as genital, itchy or itchy, painful thighs or buttocks. Then, the genitals, buttocks, anus, or other parts of the body can be significantly ulcerated. These injuries will heal in a few weeks, but for most people, the disease will recur. Although herpes can't be cured, it can be controlled by taking antiviral drugs. These drugs can reduce the frequency of the outbreak and reduce the disease. However, herpes in pregnancy can cause severe syndrome. Genital herpes is one of the reproductive infections caused by herpes simplex virus type I and type II.
Symptoms: Start with genital, itchy or itchy, painful thighs or buttocks. Then, the genitals, buttocks, anus, or other parts of the body can be significantly ulcerated. These injuries will heal in a few weeks, but for most people, the disease will recur. Herpes can not be cured.
4 trichomoniasis - This is an infection caused by parasites, the symptoms of which are vaginal secretions, discomfort during sexual intercourse, painful urination, and vaginal odor. For the patient himself, especially men, he may be unaware of trichomoniasis. Because this disease often has no symptoms. Since the disease is caused by parasites, it can be treated with antibiotics. Trichomonas vaginitis is a common disease in gynecology. It is caused by Trichomonas vaginalis. Trichomonas can be passed directly to the woman through sexual intercourse.
Symptoms: discomfort during sexual intercourse, painful urination, and vaginal odor.
5 Syphilis - This is caused by a bacterial infection that can invade the human heart, eyes, brain, bones and nervous system. The initial syphilis manifests as a painless ulcer in the genitals, usually starting 10 to 3 months after infection. Syphilis is a chronic sexually transmitted disease caused by the pallidum, Treponema pallidum. It can invade skin, mucous membranes and many other tissues and organs.
Symptoms: Painless ulcers appear in the genitals, usually starting 10 to 3 months after infection.
AIDS symptoms
Many people infected with HIV do not have any self-conscious symptoms during the incubation period, but some people may develop non-specific acute HIV infections at the early stage of infection (start of viral replication, 2-4 weeks after infection, between 5 days and 3 months). Syndrome, manifested as mononucleosis: fever, night sweats, dizziness, weakness, sore throat, discomfort, myalgia, headache, joint pain, torso rash, diarrhea, lymphadenopathy (mainly involving the armpits, occipital and neck) Lymph nodes can also develop systemic lymphadenopathy, which can last for months, even years, and other symptoms like "cold", and some people can also develop diarrhea. This symptom usually disappears after 1-2 weeks, after which the patient transitions to an asymptomatic incubation period.
Common symptoms are as follows:
(1) The general symptoms continue to have fever, weakness, night sweats, superficial lymph nodes, and the weight loss can reach more than 10% within three months, up to 40%, and the patient is particularly thin.
(2) respiratory symptoms, long-term cough, chest pain, difficulty breathing, bloody sputum in severe cases.
(3) Digestive symptoms: decreased appetite, anorexia, nausea, vomiting, diarrhea, and blood in the stool when severe. Drugs commonly used to treat digestive tract infections are ineffective for this type of diarrhea.
(4) symptoms of the nervous system dizziness, headache, slow response, mental decline, mental disorders, convulsions, hemiplegia, dementia.
(5) Skin and mucous membrane damage diffuse papules, herpes zoster, oral and pharyngeal mucosal inflammation and ulceration.
(6) Tumors can present a variety of malignant tumors. Kaposi's sarcoma on the surface of the body can be seen with red or purple-red rashes, papules, and infiltrative masses.
Examine
Genital tract infection check
White belt
The vaginal secretions were smeared and observed under a microscope. The vaginal cleanliness was determined according to the number of vaginal bacilli, white blood cells (WBC) and bacteria, and was divided into 4 degrees: I degree: a large number of vaginal bacteria and epithelial cells, no bacteria , white blood cells, clean vision, is a normal secretion. II degree: vaginal bacillus and epithelial cells, a small amount of white blood cells and bacteria, still belong to normal vaginal secretions. III degree: a little vaginal bacillus and squamous epithelium, more bacteria and white blood cells, suggesting a mild vaginal inflammation. IV degree: no vaginal bacillus, only a few epithelial cells, a large number of white blood cells and bacteria. Prompt there is relatively heavy vaginal inflammation, such as fungal vaginitis, trichomonas vaginitis.
Gynecology b super
Gynecological b-ultrasound examination 1: Congenital dysplasia of the reproductive organs, such as congenital absence of uterus, various uterine malformations (double uterus, double vagina, double-horned uterus, residual uterus, mediastinal uterus), hymen dysplasia (locking, accumulation Blood) and ectopic kidney (pelvic kidney). Gynecological b-ultrasound item 2: Endometriosis (adenosalosis, ovarian chocolate cyst). Gynecological b-ultrasound examination item 3: endometrial lesions, such as incomplete abortion, ovulation dysplasia or retention abortion, hydatidiform mole, endometrial proliferation, polyps, uterine body adenocarcinoma. Gynecological b-ultrasound item 4: Intrauterine device: to understand its position, deformation, incarceration, perforation, outing or ring pregnancy. Gynecological b-ultrasound item 5: Cervical lesions: such as cervical hypertrophy, Ness cyst, polyps. Gynecological b-ultrasound examination item 6: pelvic genital inflammation: such as uterine empyema, hydrosalpinx. Gynecological b-ultrasound item 7: Seen after hysterectomy. Gynecological b-ultrasound examination item 8: gynecological non-sacral mass: such as follicular cyst, corpus luteum cyst, luteinized cyst, polycystic ovary, ovarian hematoma, ovarian crown cyst. Gynecological b-ultrasound examination item 9: gynecological tumors: 1 benign: such as uterine fibroids and various ovarian cysts. 2 malignant: such as uterine body adenocarcinoma, choriocarcinoma, primary ovarian or secondary cancer.
Cervical scraper
Use a special wooden board to turn around the cervix for one week, scrape the secretions at the junction of the scales for smear, and use Papa Nikolaow (Pap) stain or hematoxylin-eosin stain to find tumor cells. A routine examination of a gynaecological clinic.
Cytological examination
Scrape on the 1/3 of the vaginal wall, gently scrape a small amount of secretion for smear, Shore stain, for cytological examination. Calculate the percentage of underlying/middle/superficial epithelial cells (also known as the maturity index). The appearance of dense nuclear surface cells in the smear indicates that there is an estrogen effect, and there is no surface layer cells, while the lower layer cells are mainly ovarian dysfunction.
Cervical mucus examination
Including cervical mucus consistency, drawing degree (high ovulation ovulation, cervical mucus is egg white, increased elasticity, mucus drawing length up to 10cm, under the action of progesterone, cervical mucus becomes turbid, viscous, and the degree of drawing is reduced to 1~2cm), mucus crystallization type (take the cervical mucus slide on the slide and observe under low magnification microscope, the formation of fern-like crystal under the influence of estrogen, crystallize into ellipsoid under the influence of progesterone after ovulation, observe the change before and after , can detect the presence or absence of ovulation).
Pregnancy test
The chorionic gonadotropin (hCG) secreted by the embryonic trophoblast enters the maternal blood and is excreted in the urine. The hCG content in women and urine is measured to diagnose pregnancy and pregnancy-related diseases such as abortion, ectopic pregnancy, and nourishing leaf disease.
Posterior hernia puncture
When there is suspected effusion (blood or pus) in the abdominal cavity, it can be directly puncture from the posterior vaginal canal, and the fluid accumulated in the pelvic cavity can be sucked out for examination. This method is convenient and easy to use, and is an emergency diagnosis aid for ectopic pregnancy.
Basal body temperature (BBT) determination
Basal body temperature refers to the body temperature measured after a long period of sleep (6-8 hours) and before any activity has been performed after waking up. Try the mouth table for 10 minutes. Under normal circumstances, the basal body temperature of women of childbearing age increases slightly after ovulation (because progesterone can stimulate the body temperature center), higher than the follicular phase of 0.3 to 0.5 ° C, to 1 to 2 days before menstruation or the first day of menstruation . The normal basal body temperature of the normal menstrual cycle is biphasic, the high temperature phase lasts for more than 10 days, the difference between low temperature and high temperature is >0.3 °C; if the high temperature phase <10 days, the average temperature difference is <0.3 °C, should be considered as luteal insufficiency If it is a single-phase type, it is anovated. The basic body temperature is a convenient method commonly used in gynecology, mainly to understand the presence or absence of ovulation and corpus luteum function. It can be used for the diagnosis and understanding of the effects of amenorrhea, functional uterine bleeding, infertility, etc. It can also help contraception during safe period.
Diagnosis
Diagnosis and identification of reproductive tract infection
Take the infection of genital chlamydia as an example:
1. The diagnosis of genital chlamydia infection depends on the history of sexual contact, clinical manifestations and laboratory tests. When there is typical urethritis and cervicitis symptoms, the diagnosis is not difficult. However, because asymptomatic infections are more common, laboratory tests are very important.
2. Through the laboratory to determine the cause, to treat the cause, and help to treat the patient's partner to prevent further spread; can also find asymptomatic infections, help eliminate the source of infection; check in female patients Treatment of chlamydial infection will prevent the occurrence of ectopic pregnancy or infertility.
3. The test method for diagnosing Chlamydia trachomatis infection includes specimen smear microscopy, chlamydia culture, chlamydial antigen detection, DNA detection and PCR detection. Smear examination is a simple and inexpensive diagnostic method for the detection of neonatal conjunctival scraping, but it is not suitable for the diagnosis of genital chlamydia trachoma infection, because in this case, its sensitivity Both the specificity and the specificity are extremely low.
4. Chlamydia culture is the most sensitive and specific method for detecting Chlamydia trachomatis infection. The sensitivity is 70%-95%. It can be used as a confirmation test after confirmation test and treatment, but the laboratory conditions are high and expensive. The sensitivity of the antigen detection method for diagnosing Chlamydia trachomatis infection is 70%-90%, and the specificity is 83%-99%. It is fast, inexpensive, and easy to operate, but it requires high technical level for the experimental personnel. The sensitivity of PCR for diagnosis of Chlamydia trachomatis infection in genital tract is higher than that of culture method, and the specificity can reach 99%-100%, but the detection conditions and the level of the operator are high, which is easy to lead to false positive results. It is only suitable for high-grade hospitals or Institutional development.
5. In addition, in the pathological lymphocystosis and Chlamydia trachomatis epididymitis, salpingitis, the detection of serum antibody levels is helpful for diagnosis. It is worth noting that the reliability of multimedia microscopy (MDI) examinations prevalent in various types of STD clinics or institutions is not scientifically proven and its application has not been approved by national health agencies.
