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Vaginitis


Description

Vaginitis literally means an inflammation of the vagina.

Symptoms of vaginitis include:

A change in discharge, both in smell and colour.

An itching or a burning sensation in the vagina.

Discomfort when passing water, or during sex.

Causes

The most common causes of vaginitis are infections.

Thrush is an infection caused by a fungus (candida albicans). Fungus in the vagina is almost always caused by a change in the vagina's acid balance, which leads to an increase in fungus growth. Fungus is often seen after taking antibiotics.

Trichomonas is caused by a small organism called a flagellate. It is common to experience an abundant greenish-yellow discharge, an itching, burning sensation, or pain in the vagina.

Gardnerella vaginalis (bacterial vaginosis) is caused by the growth of bacteria that causes the acidity of the vagina to become more alkaline. It commonly causes a greyish, foamy discharge with a fishlike smell.

Gonorrhoea is caused by the gonococcus bacteria, and is only transmitted sexually. Gonorrhoea can be present without any symptoms, but some people have burning pain when urinating. However, gonorrhoea is rarely seen these days.

Chlamydia is an unusual cause of vaginitis, since infection often does not produce symptoms unless pelvic inflammatory disease is present. Chlamydia is a sexually transmitted disease (STD).

Herpes is caused by the herpes simplex virus and is usually a sexually transmitted disease. It is possible to infect the genital area with the virus via contact with a cold sore (the viruses are part of the same family). Herpes is seen at the entrance to the vagina as small blisters. The first time a person has herpes, fever is common, general discomfort is experienced, urination is painful, and the lips and entrance to the vagina are swollen and red.

Conventional Labs

A physical examination can help to identify the anatomic site of involvement (vulva, vagina or cervix).

A wet-mount preparation is obtained by diluting the vaginal discharge with one or two drops of 0.9 percent normal saline solution and placing it on a slide with a coverslip. Microscopic examination of a wet-mount preparation can also detect "clue cells," which are vaginal epithelial cells that are coated with the coccobacilli. The examination may also detect fungal hyphae, increased numbers of polymorphonuclear cells (seen in trichomoniasis) or round parabasal cells (seen in atrophic vaginitis).

The KOH Preparation and Whiff Test involves a slide with a 10 percent KOH solution. The test is positive in 50 to 70 percent of women with candidal infection, which present with candidal hyphae, mycelial tangles and spores.

The whiff test is positive if a "fishy" or amine odor is detected when KOH is added to the vaginal discharge. The odor results from the liberation of amines and organic acids produced from the alkalization of anaerobic bacteria. A positive whiff test is suggestive of bacterial vaginosis.

Litmus Testing for pH is done in the pooled vaginal secretions or against the lateral vaginal wall. A normal vaginal pH is between 3.8 and 4.2 (slightly acidic). Blood and cervical mucus are alkaline and alter the pH of a vaginal sample. A pH greater than 4.5 is found in 80 to 90 percent of patients with bacterial vaginosis and frequently in patients with trichomoniasi. The pH level is also high in those with atrophic vaginitis.

 

 

 

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