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Clinical Obstetrics and Gynecology Mar 1993
Review
Topics: Administration, Intravaginal; Administration, Oral; Antifungal Agents; Candidiasis, Vulvovaginal; Chronic Disease; Decision Trees; Diagnosis, Differential; Female; Gynecology; Humans; Prevalence; Recurrence; Risk Factors
PubMed: 8435940
DOI: 10.1097/00003081-199303000-00021 -
Dermatologic Clinics Apr 1992Often trivialized by the medical profession, vaginitis in adult women is not only extremely common but the source of considerable stress, and it often results in marked... (Review)
Review
Often trivialized by the medical profession, vaginitis in adult women is not only extremely common but the source of considerable stress, and it often results in marked suffering. Epidemiologic studies described in this article indicate the high prevalence of vaginitis and the large number of causes. Although the majority of infections in women are due to BV, VVC, and trichomoniasis, it is clear that many other causes exist, and we have yet to discover the cause of many clinical syndromes. Considerable progress in understanding the pathogenesis of the three common vaginitides has been made. Although excellent progress has been made by the pharmaceutical industry in providing new drugs for vaginitis, any further progress will require a better understanding of cause and pathogenesis. Vaginitis causes major symptoms and is more than a nuisance problem. Clinicians owe it to their patients to make efforts to make an accurate diagnosis and not to rely on empiric therapy.
Topics: Adult; Candidiasis, Vulvovaginal; Diagnosis, Differential; Female; Humans; Trichomonas Infections; Vaginosis, Bacterial; Vulvovaginitis
PubMed: 1606764
DOI: No ID Found -
Annals of Allergy, Asthma & Immunology... Oct 2000The reader of this review will learn about the different clinical forms of allergic vulvovaginitis. This specific and important chapter has not been previously... (Review)
Review
LEARNING OBJECTIVES
The reader of this review will learn about the different clinical forms of allergic vulvovaginitis. This specific and important chapter has not been previously summarized and described in the medical literature. Vaginal mucosa is also able to show an allergic response similarly to the nose, eyes, lungs, and skin. Physicians should be familiarized with this kind of manifestation in order to make the proper diagnosis and evaluation of this entity.
DATA SOURCES
MEDLINE searches were undertaken since 1966 for citations of any kind of allergic vulvovaginitis. Relevant reviews and articles identified in this process were surveyed for additional and earlier citations. Textbooks of medicine, gynecology, dermatology, and infectious diseases have also been consulted. Old medical textbooks and journals of allergy and internal medicine were recovered from the Division of History of the Medicine of the Faculdade de Medicina da Universidade Federal de Minas Gerais (Federal Medical College), Belo Horizonte, Brazil.
CONCLUSIONS
A great variety of allergens are able to provoke allergic reactions in the female genital tract. The immunology of the vagina, the influence of hormones, menstrual cycle, and psychologic factors are also highlighted in this review. A possibility of vaginal hyperreactivity is proposed in this text. Adequate management provides important relief of symptoms in the majority of cases.
Topics: Female; Humans; Hypersensitivity; Vagina; Vulvovaginitis
PubMed: 11061467
DOI: 10.1016/S1081-1206(10)62527-6 -
Journal of Obstetrics and Gynaecology... Mar 2015To review the evidence and provide recommendations on screening for and management of vulvovaginal candidiasis, trichomoniasis, and bacterial vaginosis.
OBJECTIVE
To review the evidence and provide recommendations on screening for and management of vulvovaginal candidiasis, trichomoniasis, and bacterial vaginosis.
OUTCOMES
OUTCOMES evaluated include the efficacy of antibiotic treatment, cure rates for simple and complicated infections, and the implications of these conditions in pregnancy.
EVIDENCE
Published literature was retrieved through searches of MEDLINE, EMBASE, CINAHL, and The Cochrane Library in June 2013 using appropriate controlled vocabulary (e.g., vaginitis, trichomoniasis, vaginal candidiasis) and key words (bacterial vaginosis, yeast, candidiasis, trichomonas vaginalis, trichomoniasis, vaginitis, treatment). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date limits, but results were limited to English or French language materials. Searches were updated on a regular basis and incorporated in the guideline to May 2014. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, and national and international medical specialty societies.
VALUES
The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). Summary Statements 1. Vulvovaginal candidiasis affects 75% of women at least once. Topical and oral antifungal azole medications are equally effective. (I) 2. Recurrent vulvovaginal candidiasis is defined as 4 or more episodes per year. (II-2) 3. Trichomonas vaginalis is a common non-viral sexually transmitted infection that is best detected by antigen testing using vaginal swabs collected and evaluated by immunoassay or nucleic acid amplification test. (II-2) 4. Cure rates are equal at up to 88% for trichomoniasis treated with oral metronidazole 2 g once or 500 mg twice daily for 7 days. Partner treatment, even without screening, enhances cure rates. (I-A) 5. Current evidence of the efficacy of alternative therapies for bacterial vaginosis (probiotics, vitamin C) is limited. (I) Recommendations 1. Following initial therapy, treatment success of recurrent vulvovaginal candidiasis is enhanced by maintenance of weekly oral fluconazole for up to 6 months. (II-2A) 2. Symptomatic vulvovaginal candidiasis treated with topical azoles may require longer courses of therapy to be resolved. (1-A) 3. Test of cure following treatment of trichomoniasis with oral metronidazole is not recommended. (I-D) 4. Higher-dose therapy may be needed for treatment-resistant cases of trichomoniasis. (I-A) 5. In pregnancy, treatment of symptomatic Trichomonas vaginalis with oral metronidazole is warranted for the prevention of preterm birth. (I-A) 6. Bacterial vaginosis should be diagnosed using either clinical (Amsel's) or laboratory (Gram stain with objective scoring system) criteria. (II-2A) 7. Symptomatic bacterial vaginosis should be treated with oral metronidazole 500 mg twice daily for 7 days. Alternatives include vaginal metronidazole gel and oral or vaginal clindamycin cream. (I-A) 8. Longer courses of therapy for bacterial vaginosis are recommended for women with documented multiple recurrences. (I-A).
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Canada; Candidiasis, Vulvovaginal; Clindamycin; Female; Humans; MEDLINE; Metronidazole; Pregnancy; Pregnancy Complications, Infectious; Premature Birth; Recurrence; Sexually Transmitted Diseases; Trichomonas Vaginitis; Vaginosis, Bacterial; Vulvovaginitis
PubMed: 26001874
DOI: 10.1016/S1701-2163(15)30316-9 -
Annales de Dermatologie Et de... Oct 2004
Review
Topics: Adolescent; Child; Child, Preschool; Diagnosis, Differential; Female; Gynecology; Humans; Infant; Pediatrics; Physical Examination; Puberty; Vulvovaginitis
PubMed: 15697083
DOI: 10.1016/s0151-9638(04)93795-7 -
Best Practice & Research. Clinical... Apr 2018Vulvovaginitis is one of the most common gynecological complaints presenting in the pediatric and adolescent female. The common causes of vulvovaginitis in the pediatric... (Review)
Review
Vulvovaginitis is one of the most common gynecological complaints presenting in the pediatric and adolescent female. The common causes of vulvovaginitis in the pediatric patient differ than that considered in adolescent females. When a child present with vulvar itching, burning and irritation the most common etiology is non-specific and hygiene measures are recommended. However these symptoms can mimic more serious etiologies including infection, labial adhesion, lichen sclerosis, pinworms and foreign body must be considered. Yeast infection is rare in the pediatric population but common in the adolescent. In the adolescent patient infections are more common. Yeast and bacterial vaginosis are commonly seen but due to the higher rate of sexual activity in this population sexually transmitted infections must also be considered.
Topics: Adolescent; Age Factors; Candidiasis, Vulvovaginal; Child; Diagnosis, Differential; Female; Gynecology; Humans; Sexual Behavior; Sexually Transmitted Diseases; Vulvovaginitis
PubMed: 28927766
DOI: 10.1016/j.bpobgyn.2017.08.014 -
CMAJ : Canadian Medical Association... Jul 2018
Topics: Child; Child, Preschool; Female; Humans; Infant; Vulvovaginitis
PubMed: 29970369
DOI: 10.1503/cmaj.180004 -
Pediatric Clinics of North America Jun 1989Measures designed to reduce the incidence of cervicitis are those that make transmission of any STD less likely. Consistent and proper use of contraception, especially... (Review)
Review
Measures designed to reduce the incidence of cervicitis are those that make transmission of any STD less likely. Consistent and proper use of contraception, especially condoms, should be encouraged. Patients with a history of cervicitis or other STDs should be targeted for being at high risk and should have periodic screening tests to search for pathogens such as N. gonorrhoeae and C. trachomatis, even at times when they are asymptomatic. Other groups, including patients with multiple sexual partners, those with genitourinary symptoms, pregnant adolescents, and some adolescent clinic populations, also should be considered at increased risk and be monitored similarly. To be effective, encounters with adolescents around matters related to sexuality and STD must be done privately and with confidentiality assured. Special attention should be paid to the adolescent's family and cultural milieu, as well as to their level of psychosocial development, so that specific needs, fears, and misconceptions can be addressed. Cervicitis and other STDs are so common and have such important personal and public health implications that identification and effective treatment are of critical importance. The general tendency to be parsimonious when fitting together signs and symptoms into a medical diagnosis must be modified when dealing with STDs as multiple concomitant infections do occur routinely.
Topics: Adolescent; Bacterial Infections; Candidiasis, Vulvovaginal; Female; Humans; Leukorrhea; Sexually Transmitted Diseases; Uterine Cervicitis; Vulvovaginitis
PubMed: 2660084
DOI: 10.1016/s0031-3955(16)36682-2 -
Comprehensive Therapy 1999Vulvovaginal symptoms are extremely common and result in millions of visits to practitioners' offices, STD clinics and emergency rooms. Vaginal infections or infectious... (Review)
Review
Vulvovaginal symptoms are extremely common and result in millions of visits to practitioners' offices, STD clinics and emergency rooms. Vaginal infections or infectious vaginitis is responsible for only a minority of symptoms and is readily diagnosed. Epidemiology, diagnosis and therapy of vaginitis is reviewed.
Topics: Adult; Animals; Anti-Infective Agents, Local; Antifungal Agents; Antitrichomonal Agents; Atrophy; Candidiasis, Vulvovaginal; Clotrimazole; Diagnosis, Differential; Dyspareunia; Female; Fluconazole; Humans; Imidazoles; Itraconazole; Ketoconazole; Male; Miconazole; Middle Aged; Nystatin; Ornidazole; Pregnancy; Pregnancy Complications, Parasitic; Tinidazole; Triazoles; Trichomonas Vaginitis; Vaginitis; Vaginosis, Bacterial; Vulvovaginitis
PubMed: 10470518
DOI: 10.1007/BF02944280 -
Pediatrics in Review Jul 1986
Review
Topics: Adolescent; Anti-Bacterial Agents; Child; Child Abuse, Sexual; Female; Humans; Vulvovaginitis
PubMed: 3332327
DOI: 10.1542/pir.8-1-12