Vaginitis: Difference between revisions
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In [[medicine]], '''vaginitis''' is "[[inflammation]] of the [[vagina]] characterized by pain and a purulent discharge."<ref>{{MeSH}}</ref> Common causes are [[trichimonas vaginalis]], [[candida | In [[medicine]], '''vaginitis''' is "[[inflammation]] of the [[vagina]] characterized by pain and a purulent discharge."<ref>{{MeSH}}</ref> Common causes are [[trichimonas vaginalis]], [[candida albicans]], and [[gardnerella vaginalis]]. [[Atrophic vaginitis]], however, is a different syndrome, not involving infection. | ||
==Diagnosis== | ==Diagnosis== | ||
The best [[symptom]]s and [[physical examination]] findings for diagnosis have been identified in a [[systematic review]] by the [http://sgim.org/index.cfm?pageId=666 Rational Clinical Examination].<ref name="pmid15026404">{{cite journal |author=Anderson MR, Klink K, Cohrssen A |title=Evaluation of vaginal complaints |journal=JAMA |volume=291 |issue=11 |pages=1368–79 |year=2004 |month=March |pmid=15026404 |doi=10.1001/jama.291.11.1368 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=15026404 |issn=}}</ref> | The best [[symptom]]s and [[physical examination]] findings for diagnosis have been identified in a [[systematic review]] by the [http://sgim.org/index.cfm?pageId=666 Rational Clinical Examination].<ref name="pmid15026404">{{cite journal |author=Anderson MR, Klink K, Cohrssen A |title=Evaluation of vaginal complaints |journal=JAMA |volume=291 |issue=11 |pages=1368–79 |year=2004 |month=March |pmid=15026404 |doi=10.1001/jama.291.11.1368 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=15026404 |issn=}}</ref> | ||
* [[Candida albicans]] usually causes itching and the absence of this finding helps exclude this pathogen. | |||
* [[Gardnerella vaginalis]] usually causes foul and the absence of this finding helps exclude this pathogen. | |||
A more recent [[meta-analysis]] estimates that the accuracy of the [[physical examination]] as compared to [[DNA probe]] testing are:<ref name="pmid19104364">{{cite journal |author=Lowe NK, Neal JL, Ryan-Wenger NA |title=Accuracy of the clinical diagnosis of vaginitis compared with a DNA probe laboratory standard |journal=Obstet Gynecol |volume=113 |issue=1 |pages=89–95 |year=2009 |month=January |pmid=19104364 |doi=10.1097/AOG.0b013e3181909f63 |url=http://www.greenjournal.org/cgi/pmidlookup?view=long&pmid=19104364 |issn=}}</ref> | |||
* [[sensitivity (tests)|sensitivity]] = 81-85% | |||
* [[specificity (tests)|specificity]] = 70-99% | |||
==Treatment== | |||
Probiotics may reduce recurrences.<ref name="pmid20659602">{{cite journal| author=Ya W, Reifer C, Miller LE| title=Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a double-blind, randomized, placebo-controlled study. | journal=Am J Obstet Gynecol | year= 2010 | volume= 203 | issue= 2 | pages= 120.e1-6 | pmid=20659602 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20659602 | doi=10.1016/j.ajog.2010.05.023 }} </ref> | |||
Atrophic vaginitis may respond to a pH-Balanced gel.<ref name="pmid21422866">{{cite journal| author=Lee YK, Chung HH, Kim JW, Park NH, Song YS, Kang SB| title=Vaginal pH-Balanced Gel for the Control of Atrophic Vaginitis Among Breast Cancer Survivors: A Randomized Controlled Trial. | journal=Obstet Gynecol | year= 2011 | volume= 117 | issue= 4 | pages= 922-7 | pmid=21422866 | doi=10.1097/AOG.0b013e3182118790 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21422866 }} </ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Latest revision as of 23:06, 21 April 2011
In medicine, vaginitis is "inflammation of the vagina characterized by pain and a purulent discharge."[1] Common causes are trichimonas vaginalis, candida albicans, and gardnerella vaginalis. Atrophic vaginitis, however, is a different syndrome, not involving infection.
Diagnosis
The best symptoms and physical examination findings for diagnosis have been identified in a systematic review by the Rational Clinical Examination.[2]
- Candida albicans usually causes itching and the absence of this finding helps exclude this pathogen.
- Gardnerella vaginalis usually causes foul and the absence of this finding helps exclude this pathogen.
A more recent meta-analysis estimates that the accuracy of the physical examination as compared to DNA probe testing are:[3]
- sensitivity = 81-85%
- specificity = 70-99%
Treatment
Probiotics may reduce recurrences.[4]
Atrophic vaginitis may respond to a pH-Balanced gel.[5]
References
- ↑ Anonymous (2024), Vaginitis (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Anderson MR, Klink K, Cohrssen A (March 2004). "Evaluation of vaginal complaints". JAMA 291 (11): 1368–79. DOI:10.1001/jama.291.11.1368. PMID 15026404. Research Blogging.
- ↑ Lowe NK, Neal JL, Ryan-Wenger NA (January 2009). "Accuracy of the clinical diagnosis of vaginitis compared with a DNA probe laboratory standard". Obstet Gynecol 113 (1): 89–95. DOI:10.1097/AOG.0b013e3181909f63. PMID 19104364. Research Blogging.
- ↑ Ya W, Reifer C, Miller LE (2010). "Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a double-blind, randomized, placebo-controlled study.". Am J Obstet Gynecol 203 (2): 120.e1-6. DOI:10.1016/j.ajog.2010.05.023. PMID 20659602. Research Blogging.
- ↑ Lee YK, Chung HH, Kim JW, Park NH, Song YS, Kang SB (2011). "Vaginal pH-Balanced Gel for the Control of Atrophic Vaginitis Among Breast Cancer Survivors: A Randomized Controlled Trial.". Obstet Gynecol 117 (4): 922-7. DOI:10.1097/AOG.0b013e3182118790. PMID 21422866. Research Blogging.