Fungal vaginitis

Fungal vaginitis

[Summary]



Fungal vaginitis (monilial or mycotic vaginitis) from fungal infections. Its incidence after Trichomonas vaginitis. Candida vaginitis was particularly prevalent in young girls, pregnant women, patients with diabetes, as well as after menopause have used larger doses of estrogen-treated patients.



[Diagnosis]




According to the typical clinical manifestations and Head seized vaginal excretion, diagnosis fungal vaginitis, are usually difficult. But atypical cases, in order to confirm the diagnosis, all with suspected mold, or understanding of the treatment effect, we must check for vaginal secretions. Vaginal secretions directly from home slide, plus a small trickle isotonic sodium chloride solution or 10% ~ 20% potassium hydroxide solution, and glass coverslips, micro-heating microscope, red, WBC and epithelial cells immediately dissolved, and mold that is linear fiber or mycelium (mycelia) in the form of, and-shoot spores or molecules (conidia) attached. However, the reliability of low (60%). If vaginal secretions from the smear Gram staining, can be found under flocks of Gram-positive stain the oval spores, or can be seen sprouting pseudohyphal cell linked with a chain or branched-shaped, easy to identify, Reliability may be raised to 80%. Is the most reliable method for fungal culture. In addition, attention should be paid to related incentives, if large doses of steroid hormones or antibiotics history, and diabetic patients to be done urine sugar and blood glucose screening.


[Treatment]




1. Change in the vaginal pH, such as drug use alkaline washing the vagina, can be 2 to 4% vaginal washing soda solution to change the mold living environment.

2. Voted with fungicides:

(1) nystatin (nestatin) vaginal suppository (including nystatin 250,000 U), vaginal insert deep, early and late to a meeting or a meeting every night, a total of two weeks.

(2) oral nystatin 500,000 U, four times daily.

(3) compound nystatin Lingshuang local Tuca, two times a day.

(4) oral ketoconazole (ketoconazole) 400mg, twice daily, a total of five days.

(5) song of adriamycin (trichomycin), as detailed in Trichomonas vaginitis treatment. In addition, oral clotrimazole (clotrimazole) or chlorobenzene imidazole 0.5 to 1 g, 3 times a day, or partial ~ 5% with a cream or ointment liniment, three to four times a day, also good effect.

(6) 1 ~ 2% Longdanzi partial solution applied, the therapy is a long time, is also very effective, very wide application, but there are disadvantages of pollution underwear.

Pregnant women suffering from fungal vaginitis, and post-healing although possible, but newborns have been the risk of infection was necessary, timely treatment to local medication suitable method Ibid.

3. Male carriers must also carry out routine treatment, which is to eliminate female patients with recurrent one of the important measures.


[Etiology:




Mold (fungus) there are many types in the body for the most important is Candida albicans. Vaginal infections 80 ~ 90% of Candida albicans cause, and the rest other kinds of yeast Candida albicans and the ball to a (Tomlopsis), the fact that the fungal vaginal Candida vaginitis or vaginal candidiasis (vagmal candidiansis). Candida albicans was oval, Health bud cells spore germination and elongation formed pseudohyphal, pseudohyphal spores associated with the component or branch chain. Candida normally is a corruption of the inhabitants can live in normal human skin and mucous membrane, or other organs in the digestive tract, often in the vagina in the presence of asymptomatic. Leucorrhea女中number of non-pregnant women, about 10%, about 30% of pregnant women in the vagina of this parasitic, when vaginal glycogen increase in the acidity rises, or in the lower body resistance circumstances, can be become pathogenic reasons, long-term use of broad-spectrum antibiotics and adrenal cortical hormones, can fungal infection has increased tremendously. Because of the two drugs could lead to the body of dysbacteriosis and changed the vaginal microbial relations between the mutual restraints, the decline in the ability of anti-infection. In addition, the lack of vitamins (vitamin B complex), a serious infectious disease, and other diseases may become expendable Candida albicans favourable breeding conditions. Pregnancy vaginal epithelial cells glycogen content increased, vaginal acid enhanced, and the pregnant women decreased renal glucose threshold often nutritional diabetes, higher sugar content in the urine and promote the growth of Candida albicans.


[Clinical]




Candida infection is the most common symptoms Leucorrhea, genital itching and vaginal burning, exogenous dysuria, map-like genital erythema (of fungal or Candida vulvovaginitis). Leucorrhea was typical for the rennet tablet, or in bulk, vaginal mucosa highly inflamed, we can see that white thrush-like plaque attached and easy to peel, its next mucosal erosion damage to the basement, or a shallow ulcers, can be a serious left Stasis grouper. Leucorrhea but does not have the typical characteristics of water samples from the sample until rennet Leucorrhea may arise, and if some is the thin-Qi serous effusion, which often contain white tablets bar. Pregnancy fungal vaginal itching symptoms is particularly serious, and even Zuowobuning, abnormal pain, can also frequency, Niaotong symptoms such as pain and sexual intercourse. In addition, there are about 10% of women and 30% of pregnant women having mold carriers, no any clinical manifestations.


[Prevention]




1. Eliminate the incidence incentives. Active treatment such as diabetes, or time out of broad-spectrum antibiotics estrogen.

2. Stress health, especially belts Qinhuan underwear. Changed clothes disinfection must be cooked to avoid cross-infection in public places.

3. Vaginal fungal often associated with other parts of fungal infection, or both interactive infections, such as oral and fungal and other gastro-intestinal. When necessary, based in these parts for examination or fungal culture. The typical clinical manifestations and / or fungal positive, should be timely treatment.

4. For refractory or recurrent vaginal fungal repeated attack patients, sexual transmission is one of the reasons leading to relapse. The woman have symptoms at least 10% of the men suffering from fungal urethritis, should be in reasonable treatment to prevent cross-infection.