INFECTIONS
IN GYNEACOLOGY
FROM disease TO TREATMENT \ INFECTIONS in gyneacology
GYNECOLOGICAL INFECTIONS
Numerous infections of the female reproductive tract are transmitted sexually, while others commonly result from an overgrowth of the bacteria or yeast that normally inhabit the vagina.1
References:
1.
Biggs, W. S., & Williams, R. M. (2009). Common Gynecologic Infections. Primary Care: Clinics in Office Practice, 36(1), 33–51. doi:10.1016/j.pop.2008.10.002
UROGENITAL TRICHOMONIASIS
Trichomonas vaginalis is an extracellular parasite that primarily infects the squamous epithelium of the genital tract. It’s likely the most common nonviral sexually transmitted infections in the world. It commonly infects the female lower genital tract and the male urethra and prostate, primarily by sexual intercourse. Global estimates indicate that among women there are 156 million new cases per year. The majority of women (85%) and men (77%) are asymptomatic. The most common symptoms are vaginal erythema, dyspareunia, dysuria, vaginal discharge (which is often diffuse, malodorous, and yellow-green in color), pruritus in the genital region.1
References:
1.
Kissinger, Patricia J et al. “Diagnosis and Management of Trichomonas vaginalis: Summary of Evidence Reviewed for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 74,Suppl_2 (2022): S152-S161. doi:10.1093/cid/ciac030
VULVOVAGINAL CANDIDIASIS
In the majority of cases, vulvo-vaginal candidiasis is caused by Candida albicans (C. albicans). Up to 20% of women with the infection may be asymptomatic. If symptoms occur, they usually consist of vulval itching, soreness and a non-offensive vaginal discharge, which may be curdy. Clinical examination may reveal vulval erythema (redness) or excoriations from scratching and vulval oedema.Vulvo-vaginal candidiasis is usually not acquired through sexual intercourse. Although treatment of sexual partners is not recommended, it may be considered for women who have recurrent infection. A minority of male partners may have balanitis, which is characterized by erythema of the glans penis or inflammation of the glans penis and foreskin (balanoposthitis).1
References:
1.
Recommendations for the treatment of Trichomonas vaginalis, Mycoplasma genitalium, Candida albicans, bacterial vaginosis and human papillomavirus (anogenital warts). Geneva: World Health Organization; 2024.
BACTERIAL VAGINOSIS
Bacterial vaginosis is one of the most common vaginal infections affecting women worldwide, with significant implications for both reproductive and overall health. Bacterial vaginosis (BV) is a vaginal disease that manifests as abnormal vaginal flora, sometimes in combination with malodorous discharge. This syndrome has been strongly associated with the absence of lactobacilli and the presence of Gardnerella vaginalis and some anaerobes. Most commonly, this presents clinically with increased vaginal discharge, typically thin and either gray or white.1
References:
1.
OduyeboOO, AnorluRI, OgunsolaFT. The effectsof antimicrobialtherapy on bacterialvaginosisin non-pregnantwomen. Cochrane Database of SystematicReviews 2009, Issue3.
MIXED TRICHOMONAS/
YEAST INFECTIONS
Mixed vaginitis is caused by the simultaneous presence of at least two vaginal pathogens, contributing to an abnormal vaginal milieu and leading to vaginal symptoms and signs. However, associations between symptoms and microbes have not been clearly elucidated. Therefore, mixed vaginitis is an inflammatory condition that remains underrecognized. Mixed vaginitis generally, involves the formation of mixed biofilms. The specific characteristics of mixed biofilms, especially their enhanced drug resistance and their ability to evade components of the host immune response, make them of high clinical importance. The most frequently reported symptoms included a change in the characteristics of discharge (color, consistency, odor), genital itching, and burning pain.1
References:
1.
SobelJD et al. CurrInfect Dis Rep (2013) 15:104–108 DOI 10.1007/s11908-013-0325-5Qi W, Li H, Wang C, Li H, Zhang B, Dong M, Fan A, Han C and XueF (2021) RecentAdvances in Presentation, Diagnosisand Treatment for Mixed Vaginitis. Front. Cell. Infect. Microbiol. 11:759795. doi: 10.3389/fcimb.2021.759795
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