Best Home Remedies to Cure Chronic BV
Bacterial vaginosis is the most common cause of vaginitis in women of childbearing age, with prevalence of 5-60 . B. Microbiology and risk factors. Bacterial vaginosis represents a change in vaginal flora characterized by a reduction of lactobacilli and an increase of Gardnerella vaginalis, Mobiluncus species, Mycoplasma hominis, anaerobic gram-negative rods, and Peptostreptococcus species. Risk factors for bacterial vaginosis include multiple or new sexual partners, early age of first coitus, douching, cigarette smoking, and use of an intrauterine contraceptive device.
Candida vulvovaginitis accounts for one-third of vaginitis. Up to 75 of women report having had at least one episode of candidiasis. The condition is rare before menarche. It is less common in postmenopausal women, unless they are taking estrogen replacement therapy.
Noninfectious causes of vaginitis include irritants (eg, minipads, spermicides, povidone-iodine, topical antimycotic drugs, soaps and perfumes) and contact dermatitis (eg, latex condoms and antimycotic creams). 2. Typical symptoms, including pruritus, irritation, burning, soreness, and variable discharge, are most commonly confused with acute candida vaginitis. The diagnosis should be suspected in symptomatic women who do not have an otherwise apparent infectious cause. 3. Management of noninfectious vaginitis includes identifying and eliminating the offending agent. Sodium bicarbonate sitz baths and topical vegetable oils may provide some local relief. Topical corticosteroids are not recommended.
The most common congenital fungal infection is caused by Candida sp. Although Candida vaginitis is a very common complication of pregnancy, it rarely results in chorioamnionitis. The risk of Candida colonization is increased with cerclage or the presence of other foreign bodies and coexistent infection (64). Term infants may be colonized but are usually asymptomatic. Candida funisitis is life-threatening in a preterm infant.
Symptoms of vaginitis include vaginal discharge, pruritus, irritation, soreness, odor, dyspareunia and dysuria. Dyspareunia is a common feature of atrophic vaginitis. Abdominal pain is suggestive of pelvic inflammatory disease and suprapubic pain is suggestive of cystitis.
The vulva usually appears normal in bacterial vaginosis. Erythema, edema, or fissure formation suggest candidiasis, trichomoniasis, or dermatitis. Trichomonas is associated with a purulent discharge candidiasis is associated with a thick, adherent, cottage cheese-like discharge and bacterial vaginosis is associated with a thin, homogeneous, fishy smelling discharge. The cervix in women with cervicitis is usually erythematous and friable, with a mucopurulent discharge. Abdominal or cervical motion tenderness is suggestive of PID.
Measurement of vaginal pH should always be determined. The pH of the normal vaginal secretions is 4.0 to 4.5. A pH above 4.5 suggests bacterial vaginosis or trichomoniasis (pH 5 to 6), and helps to exclude candida vulvovaginitis (pH 4 to 4.5). B. Saline microscopy should look for candidal buds or hyphae, motile trichomonads, epithelial cells studded with adherent coccobacilli (clue cells), and polymorphonuclear cells (PMNs). The addition of 10 potassium hydroxide to the wet mount is helpful in diagnosing candida vaginitis. Culture for candida and trichomonas may be useful if microscopy is negative. Clinical Manifestations of Vaginitis Bacterial VaginosisBact erial Vaginosis Atrophic Vaginitis
Bacterial vaginosis (BV) is characterized by changes in the microbiological flora of the vagina, where there is a transition from Lactobacillus sp to Gram-negative and anaerobic bacteria. The most characteristic organisms are Gardnerella vaginalis, Chlamydia, Myocoplasma, and anaerobes such as Bacteroides andMobiluncus (42,43). There are no studies correlating the clinical diagnosis of BV and placental pathology. BV is associated with second trimester fetal loss and premature delivery (44,45). Pla-cental changes often include severe chorioamnionitis, which is frequently necrotizing and polymicrobial (43).
Sexually transmitted diseases (STD) are a diverse group of viral, bacterial, protozoal, and ectoparasitic infections that have a common route of transmission through sexual intercourse. Infectious organisms associated with STDs include Chlamydia trachomatis Neisseria gonorrhoeae bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis syphilis herpes simplex papillomavirus (genital warts) genital herpes and HIV. Infection by each of the above organisms has its own pattern of clinical patterns medications treatments prognosis transmission dynamics host response to infection and patterns of sexual contact.
As little is known about the yeast host interaction in Candida species other than C. albicans, this unit details the materials and experimental procedures required for development of experimental C. albicans infections, such as GI and disseminated infections in infant Swiss White mice (see Basic Protocol 1) and in adult immunocompromised BALB c mice (see Alternate Protocol 1), primary acute disseminated infection in BALB c and DBA 2 mice (see Basic Protocol 2), and vaginal infection in CBA J mice (see Basic Protocol 3) and in Wistar rats (see Alternate Protocol 2). Detailed materials and methods for C. albicans growth and detection are also described (see Support Protocols 1 to 3). The reader may wish to consult the literature for details regarding modifications of the specified protocols in different mouse and rats strains (see Commentary for additional discussion).
Although immunodeficient mice are extremely susceptible to GI and disseminated candidiasis, they are not overtly susceptible to mucosal candidiasis of the genitourinary tract (Cantorna et al., 1990). Local immune and nonimmune mechanisms appear to play a pivotal role in the control of C. albicans infection in the vagina (De Bernardis et al., 1999 Fidel and Sobel, 1998). In women, hormonal changes (especially estrogen) and local TH cell dysregu-lation greatly influence resistance to mucosal colonization and predispose to recurrent vaginitis (Fidel and Sobel, 1996). The influence of estrogen on Candida infectivity is clearly evident by the prerequisite of pseudoestrus in animal models of vaginitis, which show features resembling those described for human vaginal infection (Fidel et al., 1993 Ryley and McGregor, 1986 Sobel et al., 1985). Moreover, there is data suggesting that estrogens enhance vaginal epithelial avidity of Candida (Kinsman and Collard, 1986) and that yeast cells possess...
The majority of women, including pregnant women, with chlamydial infection are asymptomatic. Results from a National Institutes of Health-sponsored multicenter study of 8000 pregnant women (Vaginal Infection and Prematurity Study Group) found that cervical polymorphonuclear (PMN) leukocytes were poor predictors of the existence of chlamydial infection (8). The predictive values of cervical mucopus and cervical PMNs were lower than those reported in nonpregnant women. Cervical friability was also an insensitive indicator. Infection with C. trachomatis in pregnancy has been inconsistently linked to preterm delivery, low birth weight, and premature rupture of the membranes. A major problem with several of these studies has been the confounding presence of other infections, especially the genital mycoplasmas (Mycoplasma hominis and Ureaplasma urealyticum) and the organisms involved with bacterial vaginosis, which also may have adverse effects on the pregnancy and fetus (5,10). Results...
Infants born to Chlamydia-positive mothers also may become infected in the rectum and vagina (14). Although infection at these sites appears to be totally asymptomatic, the infection may cause confusion if detected later, especially in the setting of suspected child sexual abuse. Subclinical rectal and vaginal infection may occur in as many as 14 of infants born to Chlamydia-positive women some of these infants still were culture-positive at 18 months of age (17).
Oral candidiasis recurrent salivary gland swelling nasal dryness with recurrent infections, hoarseness, and aphonia atrophic changes in the vulva and vagina, resulting in pruritus and vaginitis anal and rectal mucosal dryness Skin symptoms xerosis decreased sweating dry, sparse hair annular, red, scaly plaques, especially on face and neck cutaneous vasculitis
Any pregnant woman with a vaginal discharge or inflamed vulvovaginal area should be evaluated for Candida. Candida vulvovaginitis is the second most common cause of vaginitis after bacterial vaginosis. Many women are asymptomatic, but the classic signs are a profuse, pruritic, thick, white, curdlike discharge associated with dysuria, dys-pareunia, and pruritus ani. The diagnosis of Candida vulvovaginitis is a clinical diagnosis that is confirmed by culture and microscopic detection of the yeast. A drop of the cervicovaginal fluid should be immersed in a 10 potassium hydroxide (KOH) preparation on a glass slide with a coverslip for microscopic examination. Sometimes, this
Vaginitis is an inflammation of the vagina that includes three infections Candidiasis, trichomoniasis, and bacterial vaginosis. Generally, it occurs with a hormonal imbalance and an infection with a microorganism. Vaginitis is associated with changes in normal flora, alkaline pH, insertion of foreign bodies such as tampons and condoms, chemical irritations from douches and sprays, and medications such as broad-spectrum antibiotics.
DNA by complex formation or strand breakage. This occurs in obligate anaerobes, i.e., bacteria growing under O2 exclusion. Under these conditions, conversion to reactive metabolites that attack DNA takes place (e.g., the hydroxyl-amine shown). The effect is bactericidal. A similar mechanism is involved in the antiprotozoal action on Trichomonas vaginalis (causative agent of vaginitis and urethritis) and Entamoeba histolytica (causative agent of large bowel inflammation, amebic dysentery, and hepatic abscesses). Metronidazole is well absorbed via the enteral route it is also given i.v. or topically (vaginal insert). Because metronidazole is considered potentially mutagenic, carcinogenic, and teratogenic in the human, it should not be used longer than 10 d, if possible, and be avoided during pregnancy and lactation. Timidazole may be considered equivalent to metronidazole.
Once vaginitis is diagnosed, the primary treatment is pharmacologic. Patients are told to stop using any douches and feminine hygiene sprays, to observe good nutrition, and to maintain healthy exercise patterns. Single 2-g dose PO for patient and sexual partner 500 mg bid for 7 days for bacterial vaginosis Disrupts susceptible microorganisms and acts as a bactericidal drug used to treat trichomoniasis or bacterial vaginosis Other Drugs Bacterial vaginosis may also be treated with metronidazole vaginal gel, oral clindamycin, and clindamycin vaginal cream. Encourage the patient to get adequate rest and nutrition. Encourage the patient to use appropriate hygiene techniques by wiping from front to back after urinating or defecating. Teach the patient to avoid wearing tight-fitting clothing (pantyhose, tight pants or jeans) and to wear cotton underwear rather than synthetics. Explain to patients that the risk of getting vaginal infections increases if one has sex with more than one person....
Uses Should not be used for trivial infections. Systemic. Serious respiratory tract infections (e.g., empyema, lung abscess, pneumonia) caused by staphylococci, streptococci, and pneumococci. Serious skin and soft tissue infections, septicemia, intraabdominal infections, pelvic inflammatory disease, female genital tract infections. May be the drug of choice for Bacteroides fragilis. In combination with aminoglycosides for mixed aerobic and anaerobic bacterial infections. Staphylococci-induced acute hematogenous osteomyelitis. Adjunct to surgery for chronic bone joint infections. Bacterial endocarditis prophylaxis. Non-FDA Approved Uses Alternative to sulfona-mides in combination with pyri-methamine in the acute treatment of CNS toxoplasmosis in AIDS clients. In combination with primaquine to treat Pneumocystis carinii pneumonia. Chlamydial infections in women. Bacterial vaginosis due to Gardnerella vaginalis. Topical Use. Used topically for inflammatory acne vulgar-is. Vaginally to...
Vaginitis in rodents is inducible under conditions of pseudoestrus. Mice given a vaginal inoculum of C. albicans under these conditions acquire a persistent vaginal infection, while mice inoculated in the absence of estrogen resolve the infection within 3 weeks. This protocol describes vaginal candidiasis in estrogenized CBA J mice, a model of infection particularly suitable for studies on local and peripheral immune reactivity occurring in this infection.
The majority of SABs are caused by chromosomal abnormalities that are incompatible with life the majority also have autosomal trisomies. Maternal infections, such as Mycoplasma hominis, Ureaplasma urealyticum, syphilis, HIV, group B streptococci, and second trimester bacterial vaginosis, increase the risk for an SAB. Inherited disorders or abnormal embryonic development resulting from environmental factors (teratogens) may also play a role. Patients who are classified as habitual aborters (three or more consecutive SABs) usually have an incompetent cervix that is, a situation in which the cervix is weak and does not stay closed to maintain the pregnancy. Occupation may also be a consideration if the woman is exposed to teratogens.
Smears that are unsatisfactory for evaluation may have scanty cellular material or may be obscured by inflammation, blood, or debris so that more than 75 percent of the cells are uninterpretable. Unsatisfactory Pap smears should always be repeated in two to four months. If the cells are obscured by inflammation, an attempt should be made to clear the inflammatory process (eg, treat cervicitis or vaginitis) prior to repeating the smear.
In a multicenter study, including 2322 women, the Pearl Index of efficacy in compliant patients was 0.8. Irregular bleeding was uncommon (5.5 of cycles), and withdrawal bleeding occurred in 98.5 of cycles. Compliance was 86 , with 15 of women discontinuing treatment because of an adverse event, most commonly device-related discomfort, headache, or vaginal discharge vaginitis. Only 2.5 of discontinuations were device related.
Danazol (Danocrine) has been highly effective in relieving the symptoms of endometriosis, but adverse effects may preclude its use. Adverse effects include headache, flushing, sweating and atrophic vaginitis. Androgenic side effects include acne, edema, hirsutism, deepening of the voice and weight gain. The initial dosage should be 800 mg per day, given in two divided oral doses. The overall response rate is 84 to 92 percent.
The vaginal pH is typically 4 to 4.5, which distinguishes candidiasis from Trichomonas or bacterial vaginosis. The diagnosis is confirmed by finding the organism on a wet mount adding 10 potassium hydroxide facilitates recognition of budding yeast and hyphae. Microscopy is negative in 50 of patients with vulvovaginal candidiasis.
Special Concerns Use with caution, if at all, during lactation. Give a lower initial dose in liver impairment. Safety and efficacy have not been determined in children less than 2 years of age. Side Effects Most commonly, headache, somnolence, fatigue, and dry mouth. GI Altered salivation, gastritis, dyspepsia, stomatitis, tooth ache, thirst, altered taste, flatulence. CNS Hypoesthesia, hyperkinesia, migraine, anxiety, depression, agitation, paroniria, amnesia, impaired concentration. Ophthalmologic Altered lacrimation, conjunctivitis, blurred vision, eye pain, blepharo-spasm. Respiratory Upper respiratory infection, epistaxis, pharyngitis, dyspnea, coughing, rhinitis, sinusitis, sneezing, bronchitis, bronchospasm, hemoptysis, laryngitis. Body as a whole Asthenia, increased sweating, flushing, malaise, rigors, fever, dry skin, aggravated allergy, pruritus, purpura. Musculoskeletal Back chest pain, leg cramps, arthralgia, myalgia. GU Breast pain, menorrha-gia, dysmenorrhea, vaginitis....
Suppresion of the normal flora of the body, which in turn keeps certain pathogenic microorganisms, such as Candida albicans, Proteus, or Pseudomonas, from causing infections. If the flora is altered, superinfections (monilial vaginitis, enteritis, UTIs), which necessitate the discontinuation of therapy or the use of other antibiotics, can result.
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Bacterial Vaginosis Facts
This fact sheet is designed to provide you with information on Bacterial Vaginosis. Bacterial vaginosis is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina.