Prevalence of vulvovaginitis and bacterial vaginosis in patients with koilocytosis / Prevalência de vulvovaginte e vaginose bacteriana em pacientes com coilocitose

CONTEXT AND OBJECTIVE: Empirical discussion regarding an association between koilocytosis and vulvovaginitis often occurs. Thus, the objective of this study was to assess the prevalence of microorganisms associated with bacterial vaginosis and vulvovaginitis in women with and without koilocytosis. DESIGN AND SETTING: Analytical cross-sectional study including two cohorts of women (with and without koilocytosis) who attended a cancer hospital in the city of Goiânia, state of Goiás. METHODS: A total of 102 patients entered the study. The whiff test, Gram and Papanicolaou staining and bacterial and fungal culturing were performed. The results were observed using univariate analysis. The odds ratio and confidence interval (CI) of the variables were calculated; P-values < 0.05 were considered significant. RESULTS: The prevalence of bacterial colonization was similar in patients with and without koilocytosis. The odds ratio for candidiasis was 1.43 (CI 1.05-1.95) and the odds ratio for trichomoniasis was 1.78 (CI 1.49-2.12), in patients with koilocytosis. CONCLUSIONS: The prevalence of candidiasis and trichomoniasis seems to be higher in patients with koilocytosis.

CONTEXTO E OBJETIVO: Existe uma discussão empírica sobre a associação de coilocitose e vulvovaginite. Assim, o objetivo deste estudo foi saber a prevalência de microorganismos associados à vaginose bacteriana e à vulvovaginite em mulheres com e sem coilocitose. DESENHO E LOCAL: Estudo transversal analítico, que incluiu duas coortes de mulheres, com e sem coilocitose, atendidas em um hospital de referência de câncer, na cidade de Goiânia, estado de Goiás. MÉTODOS: Um total de 102 pacientes entrou no estudo. Foram feitos os testes whiff, Gram e Papanicolaou, além de cultura para bactérias e fungos. Utilizou-se análise univariada, com o cálculo do risco relativo e do intervalo de confiança (IC). Considerou-se significativo quando valor de P < 0,05. RESULTADOS: A prevalência de colonização bacteriana foi similar em pacientes com e sem coilocitose. O risco relativo para candidíase observado em mulheres com coilocitose foi de 1,43 (IC 1,05-1,95) e, para tricomoníase, 1,78 (IC 1,49-2,12). CONCLUSÃO: A prevalência de candidíase e de tricomoníase parece ser maior nas pacientes com coilocitose.

Prevalence of vulvovaginitis and bacterial vaginosis in patients with koilocytosis.

CONTEXT AND OBJECTIVE: Empirical discussion regarding an association between koilocytosis and vulvovaginitis often occurs. Thus, the objective of this study was to assess the prevalence of microorganisms associated with bacterial vaginosis and vulvovaginitis in women with and without koilocytosis. DESIGN AND SETTING: Analytical cross-sectional study including two cohorts of women (with and without koilocytosis) who attended a cancer hospital in the city of Goiânia, state of Goiás. METHODS: A total of 102 patients entered the study. The whiff test, Gram and Papanicolaou staining and bacterial and fungal culturing were performed. The results were observed using univariate analysis. The odds ratio and confidence interval (CI) of the variables were calculated; P-values < 0.05 were considered significant. RESULTS: The prevalence of bacterial colonization was similar in patients with and without koilocytosis. The odds ratio for candidiasis was 1.43 (CI 1.05-1.95) and the odds ratio for trichomoniasis was 1.78 (CI 1.49-2.12), in patients with koilocytosis. CONCLUSIONS: The prevalence of candidiasis and trichomoniasis seems to be higher in patients with koilocytosis.

[Enterobiasis among schoolchildren in a rural population from Estado Falcón, Venezuela, and its relation with socioeconomic level]. / Enterobiasis en escolares de una población rural del Estado Falcón, Venezuela y su relación con el nivel socio-económico.

Between may and july 2001, a survey was conducted in order to investigate the prevalence and symptoms of Enterobius vermicularis infection and its relationship with the socio-economic status and household crowding of 154 schoolchildren aged 6-12 years from a rural village in Falcon State, Venezuela. The Graham technique (perianal swabs with an adhesive cellulose tape) was used to perform the parasitological diagnosis. The overall prevalence was high (57.79%). There was no difference in the prevalence between sexes (X2 = 0.005; d.f. = 1) or ages (X2 = 3.63; d.f. = 6) (p > 0.05), suggesting similar risk conditions for all individuals. Anal pruritus was the most common clinical finding (53.9%). Other less frequent manifestations were the following: perianal lesions (34.8%) and vulvovaginitis (32.6%). Graffar analysis revealed that the majority of schoolchildren belong to the poorer socioeconomic strata: IV (55.9%) and V (29.87%), with overcrowded living conditions. The correlation between E. vermicularis infection and crowding rates was found to be statistically significant (r = 0.98; p < 0.001). In the light on these results, it can be concluded that poverty, overcrowding, anal pruritus, scarcity of water, inadequate personal and community hygiene play a relevant role on the transmission dynamics and endemic maintenance of enterobiasis among schoolchildren from Sabaneta.

[Vulvovaginitis caused by Candida spp. and Trichomonas vaginalis in sexually active women]. / Vulvovaginitis por Candida spp. y Trichomonas vaginalis en mujeres sexualmente activas.

Vulvovaginitis accounts for 20 to 30% of gynecological diseases and it is observed in women from 20 to 30 years of age. It has a higher frequency in women using oral contraceptives and during the third trimester of pregnancy. The aim of this research was to assess the prevalence of Candida spp and Trichomonas vaginalis in patients with the diagnosis of vulvovaginitis from the Gynecology Service in Hospital Universitario "Ruiz y Páez" in Ciudad Bolívar and Hospital "Raúl Leoni" in San Félix (Bolívar State, Venezuela). Two hundred women with symptoms of vulvovaginitis were examined, and samples were taken from the uterocervical cul-de-sac. Each patient was asked to fill a questionnaire. The following studies were made in each sample: a) fresh wet mount examination, b) orange acridine and Giemsa stains for Trichomonas and c) culture for the identification of yeasts. The latter were identified by means of the germinal tube assay, resistance to actidione and the presence of clamidospores in rice-cream agar and sugar utilization test, using the commercial kit ID32C (BioMérieux). Only in 57 women of 200 patients with vulvovaginitis the causative agent was demonstrated; Candida spp was present in 84.2% (n = 48) and Trichomonas vaginalis in 14% (n = 8). A single case of Zygosaccharomyces spp (1.8%) was detected. The age group mainly affected was that of 25-35 years old, the 38.6% of the studied population. Candida species detected were: C. albicans in 87% of cases (n = 42), C. glabrata, in 10.42% (n = 5), and C. guillermondii, in 2.08 (n = 1). Vaginal flux, vulvar pruritus and leucorrhoea were observed in significant number of patients with vulvovaginal candidiasis. The use of antibiotics was considered predisposing factor for Trichomonas vaginalis infection. The relationship between age and the etiological agent was not statistically significant. Due to the low specificity of clinical manifestations of infections caused by Candida spp and Trichomonas vaginalis, we conclude that performing the etiologic diagnosis of vulvovaginitis is necessary in order to take the appropriate therapeutic and preventive measures, specially in those patients with a recurrent disease.

Unilateral salpingitis due to enterobius vermicularis.

A case of unilateral salpingitis caused by Enterobius vermicularis presenting as a painful adnexal mass in a 28-year-old woman is reported.

[Vulvovaginitis]. / Vulvo-vaginites.

Candidiasis, infection due to Trichomonas vaginalis and bacterial vaginosis (Gardnerella vaginalis and/or other species) represent the major three causes of vulvo-vaginitis. Other are rare bacterial infections and non infectious vaginitis such as allergic and post-menopausal vaginitis with epithelial atrophy. Clues for the diagnosis include the clinical features of vaginal discharge, cytological examinations, bacterial and fungal cultures. Only T. vaginalis seems to be responsible of sexually transmitted disease. All appropriate antibacterial or anticandidosic treatment are immediately effective, but the mechanisms of recurrent candidiasis and vaginosis are still unclear.

Severe vaginal infection with Entamoeba histolytica in a woman who recently returned from Mexico: case report and review.

Genital amebiasis is a rare complication of infection with Entamoeba histolytica, even in areas where the pathogen is endemic. We describe a patient who apparently contracted intestinal amebiasis on a trip to Mexico and who presented with ulcerative vulvovaginitis 2 months later. Her condition rapidly progressed to severe necrotizing vulvovaginitis that required a radical vulvectomy. Histopathologic examination of the surgical specimen revealed the presence of E. histolytica trophozoites. The patient recovered after surgery and antiamebic therapy. We review the epidemiology and pathogenesis of genital amebiasis as well as therapy for this rare infection.

Etiologies fongique et parasitaire des vulvo-vaginites a Abidjan. [lettre]

Une etude retrospective d'une annee d'activite allant de janvier 1989 a decembre 1989 du laboratoire de parasitologie-mycologie de la Faculute de Medecine d'Abidjan; portant sur 124 prelevements vaginaux; a permis aux auteurs de trouver un taux de positivite globale de 56;45 pour cent. Par ordre de frequence; ils ont trouve Candida albicans a un taux de 38;70 pour cent; Candida tropicalis 5;64 pour cent; puis Candida guillermondii 0;80 pour cent. Au cours de cette meme etude; Trichomonas vaginalis a ete mis en evidence 17 fois par l'examen direct; soit une prevalence de 13;70 pour cent

[Microbiological evaluation of the effectiveness of gynalgin in the treatment of vaginitis]. / Ocena mikrobiologiczna skutecznosci Gynalginu w zapaleniach pochwy u kobiet.

The microbiological effectiveness of the preparation Gynalgin produced by POLFA Pharmaceutical Works in Rzeszów was assessed in cases of vulvovaginitis in 55 patients with clinically diagnosed inflammatory conditions of the lower genital tract, who were given Gynalgin tablets in 10-day courses. Vaginal smears were examined three times for the presence of bacteria, fungi and trichomonas vaginalis (before and immediately after the treatment, and two weeks later). In the initial examination in five vaginal smears mixed bacterial flora was found, in 6 smears trichomonas was present, in 4--bacteria and fungi, and in one--trichomonas and fungi. After the treatment in control examinations I and II the number of the isolated bacterial strains was lower, trichomonas was no longer present, and the number of fungi was reduced evidently. In the light of these microbiological examinations Gynalgin was found to exert a strong fungicidal, bactericidal and antitrichomonal activity, and the results of laboratory investigations agreed with those of clinical trials of Gynalgin effectiveness.

Etiología de la vulvovaginitis en la edad pediátrica / Etiology of vulvovaginitis in pediatric age

Se describen los hallazgos obtenidos en los examenes bacteriológicos, micológicos y parasitológicos en 100 niñas que consultaron por vulvovaginitis a la unidad de ginecología pediátrica del Hospital Luis Calvo Mackenna entre los meses de noviembre de 1988 a julio de 1989. En todas las pacientes se obtuvieron muestras de secreción vaginal para estudio de bacterias, hongos y trichomonas y en 55 se realizó la prueba de Graham con cinta adhesiva transparente para detección de huevos de Enterobius vermicularis en el área perianal. Se consiguió identificar al presunto agente etiológico en 81%de los casos, correspondiendo éste en 68%a bacterias, en 4%a hongos, 1%trichomonas vaginalis y 8%Enterobius vermicularis

[Etiology of vulvovaginitis in childhood]. / Etiología de la vulvovaginitis en la edad pediátrica.

A prospective study on the causal microorganism of vulvovaginitis was done to 100 ambulatory patients seen at a pediatric gynecology unit of a metropolitan hospital at Santiago, Chile, from november 1988 throughout july 1989. Samples of vaginal discharge were taken from each patient and studied for bacteria, fungi and trichomonas. Search of pinworms was also done in 55 patients by the transparent adhesive tape test. It was possible to confirm the etiology of vulvovaginitis in 81 cases. Bacteria were isolated in 68 of them, fungi in 4, Trichomonas vaginalis in one patient and pinworms in 8.

Vulvovaginitis infecciosa en adolescentes: estudio parasitológico, bacteriológico y micológico / Infectious vulvovaginitis in adolescent girls: parasitological, bacteriological and micological study

En 50 niñas adolescentes (11-18 años de edad) que consultaron por leucorrea y/o vulvovaginitis se realizó examen parasitológico, bacteriológico y micológico del flujo vaginal, más el estudio de infección por oxiuros. De ellas, 28(56%) fuerón encontradas positivas a algún agente infeccioso, que en el 22% correspondió a bacterias, 20% a Enterobius vermicularis, 18% a Candida albicans y 10% a Trichomonas vaginalis. La mayor parte de estos agentes fueron encontradas en niñas mayores de 14 años. Estas cifras representan valores intermediosentre los que se encuentran en niñas de edad infantil y mujeres adultas con igual patología en nuestro país, aunque se aproximan más a los de las mujeres adultas, tal vez por que el grupo estudiado estuvo constituido principalmente por niñas mayores de 14 años (38 de las 50).

[Prevention and epidemiology of trichomonal vaginitis in women treated in gynecological departments]. / Profilaktyka i epidemiologia rzesistkowicy pochwy kobiet leczonych w oddzialach ginekologicznych.

The purpose of the work is to present the results of prophylactic actions used in the Departments of the Institute of Obstetrics and Gynecology of the Medical Academy in Bia l ystok giving reasons for changes and modifications concerning the present state of procedures. At the same time, attention has been paid to some epidemiological factors of trichomoniasis in women treated in gynecological departments for various diseases of the female genital organ. Women treated in the Departments of the Institute of Obstetrics and Gynecology in 1974-1975 were included in these studies. Total number of the investigated women was 9000 but those with trichomoniasis were 610. There were presented the results of procedures at the admittance rooms of the Gynecological Departments in which examinations and treatment of trichomoniasis, in reasonable cases, were carried out before admitting the patients to proper gynecological treatment were presented. The whole of the evaluation was based on our own scheme of microbiological procedures.