Agents of Female Genital Infections

In women, a urethral infection usually coincides with a bladder infection. We independently monitor infections of the vulva, vagina and cervix, uterus, ovaries and fallopian tubes.

Vulvovaginitis

• Itching, burning, discharge;
• previously the disease was classified according to the findings in the VMI (Vaginal Microbial Image), today more according to aetiology.

Viral Vaginosis

• Herpes genitalis, HSV-2, HSV-1;

• blisters on the genitals, later pustules;
• unpleasant benign disease, dangerous in pregnancy;
• dg: clinical signs, virus culture, PCR;
• therapy: aciclovir.

Bacterial Vaginosis

• Common disease, consequence of vaginal dysmicrobia;
• reduction of the amount of lactobacilli in vaginal secretion, overgrowth of other bacteria, especially anaerobes (bacteroids, eptostreptococci, fusobacteria);

• Gardnerella vaginalis, Mobiluncus;

• dg: Amsel's criteria - typical discharge, positive amine test (fish odor), microbiological examination of discharge - finding altered epithelia covered with bacteria, vaginal pH> 4.5;
• therapy: metronidazole; untreated vaginosis can result in pelvic inflammation.

Aerobic vaginitis - dysmicrobia, aerobic species predominate, especially E. coli, enterobacteria, candidas.

Lactobacillosis - pathogenic strains of lactobacilli.

Vulvovaginal candidiasis - predisposition: decompensated DM, immune disorders, corticosteroids, ATB treatment.

Trichomoniasis

• Trichomonas vaginalis;

• foaming, yellow-green discharge;
• dg: vaginal pH, amine test, detection of trichomonas Ag in secretion (ELISA), therapy is necessary even for sexual partners.

Cervicitis

• N. gonorrhoeae, Chlamydia trachomatis, HSV, HPV and others;
• dg: gonococcus - culture, chlamydia - direct diagnostics (chlamydial Ag - ELISA, immunofluorescence methods, PCR).

Uterus infection

• Mostly as a result of abortion, childbirth, instrumentation;
• begins as endometritis, further affects the myometrium, parametrium to the small pelvis, sepsis;
• pyogenic bacteria, often nosocomial strains (S. pyogenes, S. agalactiae, S. aureus);
• therapy: ATB, pus drainage.

Pelvic inflammatory disease

• Chlamydia trachomatis, E. coli, bacteroids, peptostreptococci, anaerobic bacteria, Haemophilus influenzae, aerobic streptococci, Mycoplasma hominis, Ureaplasma urealyticum, N. gonorrhoeae, Actinomyces israeli;
• usually more pathogens, identification of the primary agent is problematic;
• dg: USG, fluid puncture (microbiological examination).

Links

References

• BENEŠ, Jiří, et al. Infectious medicine. 1. edition. Galen, 2009. 651 pp. ISBN 978-80-7262-644-1.