The originators of infections of the female genital tract

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

Vulvovaginitis

• Itching, burning, discharge;
• previously the disease was classified according to the finding in MOP, today rather according to etiology.

Viral

• Herpes genitalis, HSV-2, HSV-1;
• genital blisters, later pustules;
• unpleasant benign disease, dangerous in pregnancy;
• dg: clinical symptoms, virus culture, PCR;
• therapy: aciclovir.

Bacterial vaginosis

• Frequent disease, consequence of vaginal dysmicrobia';
• decrease in the amount of lactobacilli in the vaginal secretion, overgrowth of other bacteria, mainly anaerobes (bacteroids, eptostreptococci, fusobacteria);
• Gardnerella vaginalis, Mobiluncus;
• dg: Amsel's criteria - typical discharge, positive amine test (fishy smell), during microbiological examination of the secretion, the finding of changed epithelia covered with bacteria, vaginal pH > 4.5;
• therapy: metronidazole; untreated vaginosis can result in pelvic inflammatory disease.

Aerobic vaginitis - dysmicrobia, aerobic species predominate, especially E. coli, enterobacteria, candida.
Lactobacillosis - pathogenic strains of lactobacilli.
Vulvovaginal candidiasis - predisposition: decompensated DM, immune disorders, corticosteroids, ATB treatment.

Trichomoniasis

• Trichomonas vaginalis;
• foamy, yellow-green discharge;
• dg: vaginal pH, amine test, detection of trichomonad Ag in secretions (ELISA), therapy also necessary for sexual partners.

Cervicitis

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

Infection of the uterus

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

Deep pelvic inflammation

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

Links

References

• BENEŠ, George. Infectious Diseases. 1. edition. Galen, 2009. 651 pp. ISBN 978-80-7262-644-1.