ABSTRACT
One thousand eight hundred and thirty-six clinical and biological cervico-vaginal flora samples from genital infections in women observed in community practice in 1987 were compared to 368 samples collected in 2001. The diagnosis of sexually transmitted infection (STI) was rarely made. Nonetheless, examining these samples made it possible either to prescribe a specific treatment for a confirmed infection (chlamydia, trichonomiasis, candidiasis, gonococci, vaginosis), or to modify a long-term treatment that was often ineffective and sometimes badly tolerated. Not all vulvar itching, associated or not with pelvic pain, is caused by mycosis. Treatment based on a syndromic approach was often ineffective, because clinical symptoms, whether isolated or associated, even when they were suggestive of an etiology, presented only a minor positive predictive value (the PPV for the association ichting + pelvic pain was only 10% for chlamydia, but 45% for candidiasis). The diagnosis of vaginosis, suggested for the past 10 years as an improvement in the diagnosis of vulvo-vaginitis, was made in only 13% of the cases. The only significant difference in our two studies was a lower number of cases of gonococci, chlamydiae, and ureaplasms in 2001, the settings having remained identical, except for a lower number of patients in 2001.
Subject(s)
Bacterial Infections/pathology , Genital Diseases, Female/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Bacterial Infections/diagnosis , Bacterial Infections/transmission , Child , Child, Preschool , Diagnosis, Differential , Female , Genital Diseases, Female/diagnosis , Humans , Infant , Infant, Newborn , Middle Aged , Prognosis , Sexually Transmitted Diseases/epidemiology , Sexually Transmitted Diseases/transmissionABSTRACT
An immunological study of aqueous humour and serum was carried out in experimental ocular candidosis in rabbits. Anti-candida antibody titres, immunoglobulin G, and albumin levels were evaluated in the aqueous humour and in the serum. A local synthesis of anti-candida antibodies was detected in numerous rabbits at the height of clinical activity of the lesions.
Subject(s)
Aqueous Humor/immunology , Candidiasis/immunology , Endophthalmitis/immunology , Albumins/analysis , Animals , Antibodies, Fungal/analysis , Female , Immunoglobulin G/analysis , Rabbits , Serum Albumin/analysis , Time FactorsABSTRACT
An increasing frequency of ocular lesions due to Candida albicans has been reported, but clinical detection of lesions, which may cause permanent blindness, remains difficult. Hematogenous endophthalmitis caused by Candida albicans in the rabbit is a useful model to study the pathogenesis of the disease, and perhaps to find new methods of biological diagnosis. A suspension of Candida albicans was injected in 15 rabbits, according to the method described by Edwards et al. In 1975, causing uni or bilateral chorioretinitis in 12 of them. Unaffected eyes were chosen as controls. After aspiration of the anterior chamber fluid, serum and aqueous humour titres of specific antibodies were determined. A local synthesis of IgG antibodies was detected, after comparison of the titres of specific antibodies in the aqueous humour and in the serum, related to the serum and aqueous humour concentrations of IgG antibodies. According to a formula proposed by Witmer and Desmonts in ocular lesions due to different pathological agents, we calculated the "C" coefficient: C = antibody titres aqueous humor/serum x IgG serum/aqueous humor. A local synthesis of specific antibodies in cases of experimental endophthalmitis leads us to believe that aqueous humour aspiration could be used in the diagnosis of endophthalmitis in humans.