Doctors Laboratory, Inc !"#$ %ulia Drive &aldosta, 'A ()$#!

Vaginitis Symptoms and Diagnosis

&aginitis is an inflammation of the vagina characteri*ed by discharge, odor, irritation, and+or itching It is often caused by infections, some of which are associated with more serious diseases ,he most common vaginal infections are -a. bacterial vaginosis, -b. trichomoniasis, and -c. candidiasis /ome vaginal infections are transmitted through se0ual contact, but others such as yeast infections probably are not, depending on the cause Bacterial Vaginosis (BV): 1& is the most common cause of vaginitis symptoms among women of childbearing age Also 2nown as 3nonspecific vaginitis4 or 3'ardnerella-associated vaginitis4, 1& is associated with se0ual activity 1& reflects a change in the vaginal ecosystem where normal flora has been replaced by causative agents of 1&, primarily 'ardnerella vaginalis A change in se0ual partners and douching may increase the ris2 of ac5uiring bacterial vaginosis 6hile the primary symptom of 1& is an abnormal, odorous vaginal discharge, nearly half of the women with clinical signs of 1& report no symptoms /cientific studies suggest that 1& is common in women of reproductive age In the 7nited /tates, as many as )$ percent of pregnant women have 1& 8esearchers have shown an association between 1& and pelvic inflammatory disease and ectopic pregnancy 1& also can cause adverse outcomes of pregnancy such as premature delivery and low-birth-weight infants ,herefore, CDC recommends that doctors chec2 all pregnant women for 1& who previously have delivered a premature baby, whether or not the women have symptoms 1& is also associated with increased ris2 of gonorrhea and 9I& infection Trichomoniasis: ,richomoniasis, sometimes referred to as :trich,: is a common /,D that affects ! to ( million Americans yearly It is primarily an infection of the urogenital tract; the urethra is the most common site of infection in man, and the vagina is the most common site of infection in women ,richomoniasis, li2e many other /,Ds, often occurs without any symptoms <en almost never have symptoms 6hen women have symptoms, they usually appear within four to !# days of e0posure ,he symptoms in women include a heavy, yellow-green or gray vaginal discharge, discomfort during intercourse, vaginal odor, and painful urination Irritation and itching of the female genital area, and on rare occasions, lower abdominal pain also can be present ,he symptoms in men, if present, include a thin, whitish discharge from the penis and painful or difficult urination
Complications of BV: Postinduced-abortion pelvic inflammatory disease Post-hysterectomy vaginal cuff cellulitis Plasma cell endometritis In pregnant women: Amniotic fluid infection Clinical chorioamnionitis Postpartum endometritis Premature rupture of the membranes Preterm delivery Low birth weight

8esearch has shown a lin2 between trichomoniasis and two serious se5uelae - increased ris2 of 9I& transmission and deliver a low-birth-weight or premature infant

andidiasis: &aginal yeast infection or vulvovaginal candidiasis is a common cause of vaginal irritation Appro0imately => percent of all women will e0perience at least one symptomatic yeast infection during their lifetimes ?east are always present in the vagina in small numbers, and symptoms only appear with overgrowth during pregnancy, uncontrolled diabetes mellitus, use of oral contraceptives or antibiotics, use of douches, perfumed feminine hygiene sprays, and topical antimicrobial agents, and wearing tight, poorly ventilated clothing and underwear 6hether or not yeast can be transmitted se0ually is un2nown 6hen present, the most fre5uent symptoms of yeast infection in women are itching, burning, and irritation of the vagina Painful urination and+or intercourse are common Diagnosis of Bacterial Vaginosis, Trichmoniasis and andidiasis: /ince all three conditions may be asymptomatic, the diagnosis of vaginitis may not always be determined ade5uately solely on the basis of symptoms or a physical e0amination but should be based upon laboratory testing of vaginal fluid Currently the most commonly performed test is 3&aginal 6et Prep @0am 4 6hile simple to perform, wet prep e0am can miss as much as $$A of Candida, B>A of 'ardnerella and (!A of ,richomonas infections -see insert on right. Cther tests, e g , culture and stains re5uire multiple specimen collections, have low sensitivity, and results are delayed as much as four days Doctors Laboratory Inc offers a DDA-Probe ,est for the diagnosis of Candida species, 'ardnerella vaginalis and ,richomonas from vaginal fluid specimens ,his test demonstrates "E !A, )##A and "" "A specificity and E# $A, E"A and E" $A sensitivity against Candida spp , 'ardnerella vaginalis and ,richomonas, respectively, on symptomatic patients, as compared to culture and 'ram /tain methods ,he results can be available within a few hours ,he following insert describes collection and ordering procedure:

Test Name: Vaginitis Profile (Trichomonas, Gardnerella, andida) Doctors Laboratory ordering ,est Code: !!"# CP, Codes: $%&&', $%#(' and $%)$' /pecimen /ubmission: Vaginal *l+id in ,-ffirm VP... Transport System/0 .nstr+ctions on the pac1age0 /torage of 2it before and after collection: 2oom temperat+re, sta3le for %! hrs0 ,urn-around ,ime: 4ne day, res+lts may 3e a5aila3le if called in the afternoon Days test performed: 6onday *riday 7nacceptable /pecimen: (() Not 5aginal fl+id, or (!) Not collected and s+3mitted in ,-ffirm VP... Transport System/

8eferences: ) http:++www niaid nih gov+factsheets+stdvag htm ! http:++www cdc gov+std+1&+/,DFact-1acterial-&aginosis htm