The vagina can be infected with various types of bacteria, yeast or protozoa. Most women develop some kind of vaginal infection once during their entire life time. The vagina contains normal vaginal flora. The lactobacillus is the most numerous organisms to be found in a normal vagina. These organisms help maintain an acidic pH and prevent growth and development of other pathogenic bacteria or organisms. Any factor that changes the vaginal pH or the content of the lactobacillus makes the vagina prone to variety of infections. Even in normal cases the vagina gives out a peculiar odor and discharge. An infection must be suspected when the discharge becomes unusually profuse, smells foul or changes texture. The discharge will also be accompanied with pruritic or severe itching. Hence the woman may complain of itching, burning, swelling and redness around the vagina.
Specific vaginal infections:
Trichomoniasis: This is the most common vaginal infection. It is commonly seen in women during the childbearing period. It is transmitted through sexual intercourse in most cases; however it may be transmitted through infected towels or clothes. Trichomonas is a protozoon. Most women may be asymptomatic. Others develop an infection 7 to 28 days following infection with the organism. Symptoms produced are vaginal discharge which is thin, creamy, slightly green in colour, frothy and is associated with intense pruritic. On examination the vagina appears red, inflamed, angry looking. The cervix and vagina appear red as a strawberry hence is called ‘strawberry cervix’ or ‘strawberry vagina’. The patient may also complain of increased frequency of passing urine or dysuria. This vaginal infection is diagnosed by a wet film preparation of the vaginal discharge and examination under a microscope. Gram staining and culture of the discharge too may help in isolating the organism. Treatment includes administration of Metronidazole 200 mg orally three times a day for 7 days. It must be given to both the partners. The partners must be advised to avoid sexual intercourse or use a barrier contraceptive until the treatment is over.
Candidiasis: Is caused due to infection with a gram positive fungus called Candida albicans. It is a common infection in women who are pregnant or suffering from diabetes. The patient may complain thick curdy vaginal discharge, accompanied by intense pruritic. There may be soreness of the vagina, burning sensation, dysuria and dyspareunia. Treatment includes administration of antifungal medications orally and as a vaginal pessary.
Chlamydia: Is common among young and sexually active women. Chlamydia trachomatis is a gram negative bacterium. Increased use of oral contraceptive pills has increased the chances of women suffering from this infection. PCR and ELISA tests are both extremely useful for detection of the antigen. Patient presents with vaginal discharge, itching and dysuria.
Bacterial vaginosis: This vaginal infection is caused by Gardnerella Vaginalis. The patient complains of white milky vaginal discharge. It is characterized by the presence of Clue cells on a smear. This infection responds very well to a 7 day course of Metronidazole.
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