Bacterial Vaginosis

For many years the term nonspecific vaginitis was used to describe vaginal discharge whose cause was not Trichomonas vaginalis and Candida spp. In 1955 Gardner and Dukes clinically defined this condition, calling it "Haemophilus vaginalis vaginitis." Since then es up microorganism was renamed Gardnerella vaginalis.
Currently, Haemophilus vaginalis vaginitis is called bacterial vaginosis (vaginosis or anaerobic UK) because of the absence of inflammation in the vaginal epithelium. Others use the term vaginal bacteriosis, which means excess bacteria in the vagina. It is assumed that bacterial vaginosis is the result of a complex interaction of many species of bacteria. Gardner and Dukes believed that the disease was caused by G. vaginallis noticed because she was present in women without this condition.
In retrospect, it seems that they could not recover G. vaginalis latter group because the culture medium was inadequate and in women with bacterial vaginosis number of these microorganisms is much higher than in women without this condition. The use of culturing techniques more sensitive shows that approximately 50% are asymptomatic women colonized by G. vaginalis.
Treatment
Bacterial vaginosis is caused by an imbalance in the vaginal ecosystem, some clinicians have used homeopathic drugs such as yogurt, gel acetic acid, lactic acid gels and creams hormone. None of these treatments proved more effective than placebo in carefully controlled studies. It is possible that recolonisation vaginal appropriate human strains of lactobacilli may be useful in conjunction with the antimicrobial treatment, but so far no commercially available strain proved beneficial. Numerous recent studies have linked bacterial vaginosis in pregnancy complications, including premature birth, prematurity and infection of the amniotic fluid. Concern for potential carcinogenic and teratogenic effects of metronidazole limits its use during pregnancy, but this drug is considered safe for use in the second quarter.
Prevention
Some primary care can help reduce the risk of imbalance nature of the vagina and preventing the development of bacterial vaginosis:
- Use a condom during sexual intercourse
- Avoid using duchinhas
- Avoid chemicals that can cause irritation and discomfort in the genital area
Diagnosis
• Discussed the fresh or stained smear of the vaginal contents, showing the presence of "key cells" or "clue-cells", which are epithelial cells coated with bacteria attached to suasuperfície; • pH of the vaginal secretions: the measurement of pH vaginal is a quick and simple test that produzinformações valuable. This is accomplished by means of a strip of pH indicator paper placed emcontato with the vaginal wall during one minute. One should be careful not to touch ocolo, which has a more basic pH than the vagina and may cause distortions in leitura.O normal vaginal pH value ranges from 4.0 to 4.5. In bacterial vaginosis is always greater que4, 5, and • testing of amines: some amines are produced by the bacterial vaginal particularmentepelos anaerobes. These amines can be identified when the content vaginale blended with one or two drops of 10% KOH. In the presence of bacterial vaginosis occurs aliberação of amines with fetid odor, odor similar to fish podre.O diagnosis of bacterial vaginosis is confirmed when three of seguintescritérios are present, or only the last two: • homogeneous vaginal discharge, and usually grayish variable quantity; • vaginal pH greater than 4.5; • of the amines positive test; • presence of "clue cells" in bacterioscopic exam associated with the absence of lactobacilli