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Comprehensive Therapy

, Volume 25, Issue 6–7, pp 335–346 | Cite as

Vulvovaginitis in healthy women

  • J. D. Sobel
Original Article

Abstract

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.

Keywords

Metronidazole Bacterial VAGINOSIS Vaginitis Comp THER Trichomoniasis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Berg AO, Heidrich RD, Fihn SD, et al. Establishing the cause of symptoms in women in a family practice.JAMA. 1984;251:620–625.PubMedCrossRefGoogle Scholar
  2. 2.
    Geiger AM, Foxman B, Gillespie BW. Epidemiology of vulvovaginal candidiasis among university student.Am J Pub Health. 1995;85:1146–1148.PubMedGoogle Scholar
  3. 3.
    Geiger AM, Foxman B. Risk factors in vulvovaginal candidiasis: a case-control study among college students.Epidemiology. 1996;182–187.Google Scholar
  4. 4.
    Hurley R, DeLouvois J. Candida vaginitis.Postgrad Med J. 1979;55:645–647.PubMedGoogle Scholar
  5. 5.
    Odds FC. Candidiasis of the genitalia. In: Odd RC, ed. Candidaand Candidosis: A Review and Bibliography. 2nd ed. London: Balliere Tindal, 1988;124–135.Google Scholar
  6. 6.
    Horowitz BJ, Giaquinta D, Ito S. Evolving pathogens in vulvovaginal candidiasis: implications for patient care.J Clin Pharmacol. 1992;32:248–255.PubMedGoogle Scholar
  7. 7.
    Foxman B. Epidemiology of vulvovaginal candidiasis: risk factors.Am J Pub Health. 1990;80:329–331.PubMedGoogle Scholar
  8. 8.
    Ferris DG, Dekle C, Litaker MS. Women’s use of over-the-counter antifungal pharmaceutical products for gynecologic symptoms.J Fam Pract. 1996;42:595–600.PubMedGoogle Scholar
  9. 9.
    Reef S, Levine WC, McNeil MM, et al. Treatment options for vulvovaginal candidiasis. Background paper for development of 1993 STD treatment recommendations.Clin Infect Dis. 1995;20(Suppl):580–590.Google Scholar
  10. 10.
    Sobel JD, Brooker D, Stein GE, et al. Single oral dose fluconazole compared with conventional topical therapy ofCandida vaginitis.Am J Obstet Gynecol. 1995;172:1263–1268.PubMedCrossRefGoogle Scholar
  11. 11.
    Houang ET, Chappatte, Byrne D, Macrae PV, Thoiper JE. Fluconazole levels in plasma and vaginal secretions of patients with the 150 mg single dose and rate of eradication of infections in vaginal candidiasis.Antimicrob Ag Chem. 1990;34:909–913.Google Scholar
  12. 12.
    Sobel JD, Chaim W. Treatment ofCandida glabrata vaginitis: a retrospective review of boric acid therapy.Clin Infect Dis. 1997;24:649–652.PubMedGoogle Scholar
  13. 13.
    Sobel JD. Epidemiology and pathogenesis of recurrent vulvovaginal canidiasis.Am J Obstet Gynecol. 1985;152:924–934.PubMedGoogle Scholar
  14. 14.
    Vazquez JA, Sobel JD, Demitriou R, Vaishampayan J, Lynch M, Zervos MJ. Karyotyping ofC. albicans isolates obtained longitudinally in women with recurrent vulvovaginal candidiasis.J Infect Dis. 1994;170:1566–1569.PubMedGoogle Scholar
  15. 15.
    Spinillo A, Carrata L, Pizzoli G. Recurrent vulvovaginal candidiasis: Results of a cohort study of sexual transmission and intestinal reservoir.J Reproduct Med. 1992;37:343–347.Google Scholar
  16. 16.
    Fidel PJ Jr, Sobel JD. Immunopathogenesis of recurrent vulvovaginal candidiasis.Clin Micro Rev. 1996;9:335–348.PubMedGoogle Scholar
  17. 17.
    Chaim W, Foxman B, Sobel JD. Association of recurrent vaginal candidiasis and secretory ABO + Lewis phenotype.J Infect Dis. 1997;176:828–830.PubMedCrossRefGoogle Scholar
  18. 18.
    Sobel JD, Chaim W. Vaginal microbiology of women with recurrent vulvovaginal candidiasis.J Clin Micro. 1996;34:2497–2502.Google Scholar
  19. 19.
    Sobel JD, Vazquez JA. Symptomatic vulvovaginitis due to resistantCandida albicans in a female who was not infected with human immunodeficiency virus.Clin Infect Dis. 1996;22:726–727.PubMedGoogle Scholar
  20. 20.
    Lossick JC. Epidemiology of urogenital trichomoniasis. In Honigberg BM, ed.Trichomonads Parasitic in Humans. New York: Springer-Verlag; 1990;311–323.Google Scholar
  21. 21.
    Luga M, Manoka AT, Kivuvu AT, et al. Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: result from cohort study.AIDS. 1993;7:95–102.CrossRefGoogle Scholar
  22. 22.
    Hammil HA.Trichomonas vaginalis.Obstet Gynecol Clin North Am. 1989;16:531–540.Google Scholar
  23. 23.
    Wolner-Hanssen P, Krieger JN, Stevens CD et al. Clinical manifestations of vaginal trichomoniasis.JAMA. 1989;261:571–576.PubMedCrossRefGoogle Scholar
  24. 24.
    Soper DE, Bump RC, Hurt WR. Bacterial vaginosis and trichomoniasis are risk factors for cuff cellulitis after abdominal hysterectomy.Am J Obstet Gynecol. 1990;163:1016–1021.PubMedGoogle Scholar
  25. 25.
    Krieger JN, Tam MR, Stevens CE, et al. Diagnosis of trichomoniasis: comparison of conventional wet-mount examination with cytologic studies, cultures, and monoclonal antibody staining of direct specimens.JAMA. 1988;259:1223–1227.PubMedCrossRefGoogle Scholar
  26. 26.
    DeMeo LR, Draper DL, McGregor JA, et al. Evaluation of a deoxyribonucleic acid probe for the detection ofTrichomonas vaginalis in vaginal secretions.Am J Obstet Gynecol. 1996;174:1339–1342.PubMedCrossRefGoogle Scholar
  27. 27.
    Nyirjesy P, Weitz MV, Gelone SP, Fekete T. Paramomycin for nitroimidazole-resistant trichomoniasis.Lancet. 1995;346:1100.CrossRefGoogle Scholar
  28. 28.
    Kurohara ML, Kwong FK, Lebherz TB, Klaustermeyer WB. Metronidazole hypersensitivity and oral desensitization.J Allerg Clin Immunol. 1991;88:279–280.CrossRefGoogle Scholar
  29. 29.
    Hillier SL, Holmes KK. Bacterial Vaginosis In:Sexually Transmitted Diseases. Holmes KK, Mardh PA, Sparling PF, et al, eds. New York: McGraw-Hill; 1990;547–560.Google Scholar
  30. 30.
    Eschenbach DA, Davick PR, Williams BL. Prevalence of hydrogen peroxide-producingLactobacillus species in normal women and women with bacterial vaginosis.J Clin Microbiol. 1989;27:251–256.PubMedGoogle Scholar
  31. 31.
    Hill GB. Microbiology of bacterial vaginosis.Am J Obstet Gynecol. 1993;169:450–454.PubMedGoogle Scholar
  32. 32.
    Gardner H, Dukes CD.Hemophilus vaginalis vaginitis: a newly defined specific infection previously classified “non-specific” vaginitis.Am J Obstet Gynecol. 1955;69:962–976.PubMedGoogle Scholar
  33. 33.
    Amsel R, Totten PA, Speigel CA, Chen KS, Eschenbach DA, Holmes KK. Nonspecific vaginitis: diagnostic criteria and microbial and epidemiologic associations.Am J Med. 1983;74:14–22.PubMedCrossRefGoogle Scholar
  34. 34.
    Eschenbach DA, Hillier SL, Critchlow C, Stevens C, DeRauen T, Holmes KK. Diagnosis and clinical manifestations of bacterial vaginosis.Am J Obstet Gynecol. 1988;158:819–828.PubMedGoogle Scholar
  35. 35.
    Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of Gram stain interpretation.J Clin Microbiol. 1991;29:297–301.PubMedGoogle Scholar
  36. 36.
    Sheiness D, Dix K, Watanabe S, Hillier SL. High levels ofGardnerella vaginalis detected with an oligonucleotide probe combined with elevated pH as a diagnostic indicator of bacterial vaginosis.J Clin Micro. 1992;30:642–645.Google Scholar
  37. 37.
    Oleen-Burkey MA, Hillier SL. Pregnancy complications associated with bacterial vaginosis and their estimated costs.Infect Dis Obstet Gynecol. 1995;3:149–157.PubMedCrossRefGoogle Scholar
  38. 38.
    Hillier SL, Martius J, Krohn M, Kiviat N, Holmes KK, Eschenbach DA. A case-control study of chorioamnionic infection and histologic chorioamnionitis in prematurity.N Engl J Med. 1988;319:971–978.Google Scholar
  39. 39.
    Eschenbach DA. Bacterial vaginosis: emphasis on upper genital tract complications.Obstet Gynecol Clin North Am. 1989;16:593–610.PubMedGoogle Scholar
  40. 40.
    Kurk T, Sivonen A, Renkonen O, Savia F, Ylikorkala O. Bacterial vaginosis in early pregnancy and pregnancy outcomes.Obstet Gynecol. 1992;80:173–177.Google Scholar
  41. 41.
    Hay PE, Lamont RF, Taylor-Robinson D, Morgan DJ, Ison C, Pearson J. Abnormal bacterial colonization of the genital tract and subsequent preterm delivery and late miscarriage.Br Med J. 1994;308:295–298.Google Scholar
  42. 42.
    McGregor JA, French JJ, Parker R, et al. Prevention of premature birth by screening and treatment of common genital tract infections: results of a propsective controlled evaluation.Am J Obstet Gynecol. 1995;173:157–167.PubMedCrossRefGoogle Scholar
  43. 43.
    Morales WJ, Schorr S, Albritton J. Effect of metronidazole in patients with preterm birth in preceding pregnancy and bacterial vaginosis: a placebo-controlled, double-blind study.Am J Obstet Gynecol. 1994;71:345–349.Google Scholar
  44. 44.
    Hauth JC, Goldenberg RL, Andrews WW, DuBard MB, Copper RD. Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis.N Engl J Med. 1995;333:1732–1736.PubMedCrossRefGoogle Scholar
  45. 45.
    MacDermott RIJ. Bacterial vaginosis.Brit J Obstet Gynecol. 1995;102:92–94.Google Scholar
  46. 46.
    Korn AP, Bolan G, Padian N, et al. Plasma cell endometritis in women with symptomatic bacterial vaginosis.Obstet Gynecol. 1995;85:387–390.PubMedCrossRefGoogle Scholar
  47. 47.
    Platz-Christensen JJ, Sundstrom E, Larsson PG. Bacterial vaginosis and cervical intraepithelial neoplasia.Acta Obstet Gynecol Scand. 1994;73:586–588.PubMedCrossRefGoogle Scholar
  48. 48.
    Peters N, Van Leeuwen AM, Pieters WJLM, Holleman H, Quint WGV, Burger MPM. Bacterial vaginosis is not important in the etiology of cervical neoplasia: a survey of women with dyskariotic smears.Sex Trans Dis. 1995;22:296–302.CrossRefGoogle Scholar
  49. 49.
    Joesoef MR, Schmid GP. Bacterial vaginosis: review of treatment options and potential clinical indications for therapy.Clin Infect Dis. 1995;20(Suppl 1):572–579.Google Scholar
  50. 50.
    Ferris DG, Litaker MS, Woodward L, Marhis D, Hendrich J. Treatment of bacterial vaginosis: a comparison of oral metronidazole: metronidazole vaginal gel and clindamycin vaginal cream.J Fam Pract. 1995;41:443–449.PubMedGoogle Scholar
  51. 51.
    Ahmed-Jushuf, IH Shahmanesh M, Arya OP. The treatment of bacterial vaginosis with a 3 day course of 2% clindamycin cream: results of a multicenter, double blind, placebo controlled trial.Genitourin Med. 1995;71:254–256.PubMedGoogle Scholar
  52. 52.
    Fleury FJ. Adult vaginitis.Clin Obstet Gynecol. 1981;24:407–438.PubMedCrossRefGoogle Scholar
  53. 53.
    Sobel JD. Desquamative inflammatory vaginitis: a new subgroup of purulent vaginitis responsive to topical 2% clindamycin therapy.Am J Obstet Gynecol. 1994;171:1215–1220.PubMedGoogle Scholar
  54. 54.
    Gardner HL. Desquamative inflammatory vaginitis: a newly defined entity.Am J Obstet Gyn. 1968;102:1102–1105.Google Scholar

Copyright information

© the American Society of Contemporary Medicine and Surgery 1999

Authors and Affiliations

  • J. D. Sobel
    • 1
  1. 1.Division of Infectious Diseases Department of Internal MedicineWayne State University School of Medicine The Detroit Medical CenterDetroit

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