Bacterial vaginosis is not a disease in the classic sense, but, more
syndrome disorder in the composition of vaginal flora, and occurs as a result
of the symbiotic interaction effects of several different bacterial species. In
30% of cases runs completely asymptomatic or manifest more abundant vaginal
discharge zaudarajućeg character, the stale smell of fish - so called. fishy
odor. Has long been considered a less important condition, but lately is
associated with infections of the upper genital tract infections, postoperative
infections and cervical malignancies, and pregnancy causes inflammation of
membranes, preterm rupture of membranes preveremeno childbirth and inflammation
of the uterine lining. The incidence is around 15-25% of adolescent females and
25-35% of women of reproductive age. Proven infection are more often caused by
chlamydia, mycoplasma and ureaplasma with bacterial vaginosis. When there is a
reduced bacterial vaginosis lactobacilli (responsible for the creation of
lactic acid and acidity of the vagina), with increased concentrations of
bacteria which growth and reproduction is not required oxygen (anaerobes) and
Gardnerella vaginalis.
Diagnosis is based on the preparation of vaginal secretions painted by
the Gramm- Nugentovog by using scoring systems. Amsel was also given the
criteria for the diagnosis of bacterial vaginosis:
• homogeneous vaginal iscedak
• vaginal pH> 4.5
• positive amine test
findings • "clue" cells
Vaginal discharge is whitish gray, foamy milk consistency and often
abundant, characteristic odor, pH greater than 4.5 is determined by dipping the
litmus paper in the last vaginal fornix, a positive amine test is a very strong
smell of stale fish, especially after the addition of hydroxide 10%, while
finding the "clue" cells means grouping cells that are inundated
bacilli.
treatment is carried out by local or general, using metronidazole in a
dose of 2.0 g, 5-7 days, and in the U.S. is given metronidazole 500 mg 2 times
daily for 5-7 days orally with vaginal Orvagil 10 days. Efficient and
Clindamycin treatment included 300 mg, 2 times a day, 7 days with the use of
oral vaginaleta made on the basis of a Clindamycin. The efficiency of this
treatment is 70-75%. Author: Prim. Dr. Stevan Milosevic Bacterial vaginosis
Anaerobic vaginosis is the most common vaginal disorder among women of
reproductive age. Polimicrobe This is primarily anaerobic infections. It is a
consequence of impaired balance between different types of bacteria in the
vagina. Instead of the normal predominance of Lactobacillus in the vagina of
women with bacterial vaginosis there prekomeran growth of other microorganisms,
which provide a distinctive smell of vaginal secretions. Symptoms:
The main
symptom is an enhanced, gray-white, line, vaginal discharge with smell the
rotten fish, which is especially pronounced after sexual intercourse. However,
in about 50% of cases, bacterial vaginosis does not give any symptoms. Therapy:
the doctor usually prescribe topical treatment Bacterial vaginosis (BV) is a
change in vaginal microflora. Normal flora is dominated by lactobacilli is
absent or greatly reduced and replaced with a mixed, mainly anaerobic flora,
which consists of the following types of bacteria: Gardnerella vaginalis,
Mycoplasma hominis, Mobiluncus spp, Bacteroides spp, Prevotela spp, Peptostreptococcus
spp, Fusobacterium spp and Porphyromonas spp Four studies conducted and
published in the countries of the U.S., Africa and Thailand have shown that
women with bacterial vaginosis have a higher prevalence of HIV.
A large number
of epidemiological studies have found that a "dose-response"
relationship between the extent of abnormal flora in BV and the risk of HIV
infection. Understanding this "dose-response" relationship between BV
and HIV infection helps to clarify the pathogenetic mechanism of this
complication. It was also in the multi-variant model that women without
lactobacilli were 70% more likely to get gonorrhea and other sexually
transmitted diseases. In women with BV may lead to an increased risk of
salpingitis and / or endometritis, postsurgical infections (endometritis, after
cesarean section, vaginal posthisterektomijski cellulitis),
adverse
pregnancy outcomes, including premature rupture of membranes, premature labor,
and chorioamnionitis. There is a possibility that bacterial vaginosis is in
some way associated with the development of cervical intraepithelial neoplasia
(CIN). Also, there are no data linking BV with cytologic inflammatory changes
in the cervix. The association of BV with many obstetric and gynecological
complications requires mandatory screening and treatment of BV in different
clinical conditions. Additional studies of this disease must include prevention
of complications during pregnancy, as well as the treatment of BV in women who
are not pregnant.
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