vaginitis

(vaj″ĭ-nīt′ĭs)

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[vagina + -itis]

1. Inflammation of a sheath.
2. Inflammation of the vagina.
SYN: SEE: colpitis
SEE: sexually transmitted disease; SEE: vulvovaginitis.

ETIOLOGY
Inflammation of the vagina may be caused by overgrowth or invasion of organisms such as gonococci, Chlamydiae, Gardnerella vaginalis, staphylococci, streptococci, spirochetes; viruses such as herpes; irritation from chemicals in douching, hygiene sprays, detergents, menstrual products, or toilet tissue; fungal infection (candidiasis) caused by overgrowth of Candida albicans or, less commonly, other candidal species; protozoal infection, e.g., Trichomonas vaginalis; neoplasms of the cervix or vagina; poor hygiene; irritation from foreign bodies, e.g., a pessary or a retained tampon; or vulvar atrophy. Other, rare, causes are parasitic illnesses, or, in malnourished women, pellagra.

SYMPTOMS
The patient experiences vaginal discharge, sometimes malodorous and occasionally stained with blood; irritation, burning, or itching; increased urinary frequency; and pain during urination or examination. On examination, the vaginal mucous membrane is reddened, and there may be superficial maceration or ulceration.

TREATMENT
Specific therapy is given as indicated for the underlying cause. Improved perineal hygiene is emphasized by instructing in the proper method of cleaning the anus after a bowel movement, the proper use of menstrual protection materials, and the necessity of drying the vulva following urination.

PREVENTION
In addition to being taught improved perineal hygiene, patients should be encouraged to wear all-cotton underpants or panties with a cotton crotch area, not to wear underwear to bed, and to avoid tight-fitting pants or panty hose that promote moisture and growth of organisms.

PATIENT CARE
During examination of the patient, aseptic techniques are used to collect specimens. The health care provider supports the patient throughout the procedures, explaining each procedure and warning the patient of possible discomfort. The patient should be advised that persistent or recurrent candidiasis indicates a need for assessment for pregnancy or diabetes mellitus. If vaginitis is due to a sexually transmitted disease, the sexual partner should receive treatment with the patient to prevent reinfection. Certain sexually transmitted vaginal infections must be reported to local or state public health officials with the patient's known sexual contacts.

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