Medical history (history of illness) represents an important component in the diagnosis of bacterial vaginosis (amincolitis). Family history Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints). Have you noticed any symptoms such as discharge? What does this look like? … Bacterial Vaginosis: Medical History
Infectious and parasitic diseases (A00-B99). Chlamydia Gonorrhea (gonorrhea) Mycoses (fungal disease) Staphylococcus aureus Streptococcus group A, B Trichomonads Vulvitis plasmacellularis Neoplasms – tumor diseases (C00-D48) Cervical carcinoma (cervical cancer). Corpus carcinoma (cancer of the body of the uterus) Tubal carcinoma (fallopian tube cancer) Vaginal carcinoma (cancer of the vagina) Genitourinary system (kidneys, urinary tract – … Bacterial Vaginosis: Or something else? Differential Diagnosis
The following are the major conditions or complications that may be contributed to by bacterial vaginosis (amine colpitis): Certain conditions originating in the perinatal period (P00-P96). Neonatal sepsis (blood poisoning of the newborn; condition following amniotic infection syndrome). Pregnancy, childbirth, and puerperium (O00-O99). Abortion (miscarriage) Amniotic infection syndrome (AIS) – infection of the egg cavity, … Bacterial Vaginosis: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing) of the skin, mucous membranes, abdominal wall, and inguinal region (groin area). Gynecological examination Inspection Vulva (external, primary female sexual organs). Speculum setting: Vagina (vaginal) [often grayish-white and thin … Bacterial Vaginosis: Examination
1st order laboratory parameters – obligatory laboratory tests. Amine test (Whiff test) – by sprinkling the vaginal secretion (vaginal fluid) with a 10% potassium hydroxide solution typical fishy odor (= amine colpitis). Measurement of the pH of the vaginal secretion (vaginal secretion) [suspicious if pH of the vagina > 4.5]. Phase contrast microscopy of vaginal … Bacterial Vaginosis: Test and Diagnosis
Therapeutic targets Improvement of the symptomatology Restoration of normal vaginal flora Therapy recommendations Preferably use metronidazole, orally (also possible in pregnancy) or also with cream containing clindamycin (2% vaginal gel). In recurrent (re-occurring) bacterial vaginosis: for prophylaxis, if necessary also therapy probiotics (dietary supplements; see below). See also under “Further therapy“. Supplements (dietary supplements; vital … Bacterial Vaginosis: Drug Therapy
Obligatory medical device diagnostics. Phase contrast microscopy of vaginal secretions (vaginal secretions) – live, unstained cells appear extremely low in contrast in a normal brightfield microscope, these are well visualized by the phase contrast method (see below 1st order laboratory parameters). Optional medical device diagnostics – depending on the results of the history, physical examination, … Bacterial Vaginosis: Diagnostic Tests
To prevent bacterial vaginosis (amine colpitis), attention must be paid to reducing individual risk factors. Behavioral risk factors Sexual intercourse (e.g., switching from vaginal to anal or oral coitus/intercourse). Promiscuity (sexual contact with relatively frequently changing different partners). Prevention factors (protective factors) Probiotics intake (especially Lactobacillus acidophilus, Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum RC-14 ; … Bacterial Vaginosis: Prevention
The following symptoms and complaints may indicate bacterial vaginosis (BV; amine colpitis): Woman Leading symptom Thin, grayish-white homogeneous fluorine (discharge) that may have a fishy odor Rare accompanying symptoms Pruritus (itching) Redness (rarely: Vulva/external, primary sex organs; virtually never affecting the vagina/vagina). In approximately 50% of cases that meet Amsel’s diagnostic criteria for BV (see … Bacterial Vaginosis: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Etiology (cause) and pathophysiology are still unknown. Genetic and immunological factors, a gene polymorphism, psychosocial stress, also a disturbed oral flora (microbiota) in periodontitis (inflammation caused by bacteria, which manifests itself in a largely irreversible destruction of the periodontium) and a deficiency of vitamin B3 are discussed as causes. The pathophysiological … Bacterial Vaginosis: Causes
General measures Observance of the general hygiene measures! Genital hygiene Once a day, the genital area should be washed with a pH neutral care product. Washing several times a day with soap, intimate lotion or disinfectant destroys the natural acid mantle of the skin. Pure water dries out the skin, frequent washing irritates the skin. … Bacterial Vaginosis: Therapy
