Vulvovaginitis is an inflammatory disease of the labia and vagina in women that is caused by sexually transmitted infections. Among the most common causes are infections with herpes simplex virus 2 and papilloma virus, with the complication of developed condylomas. Chlamydial infections and their specific chlamydial condylomas also lead to the development of vulvovaginitis. Of the bacteria, the most well-known causative agents are staphylococcus, nayseria and gonorrheal bacteria. Candidiasis and vaginal trichomonas are the next most common causes of vulvovaginitis. Among the non-infectious causes of the disease are traumatic injuries – physical injuries after rough sexual intercourse and perversions, as well as the ingestion of foreign bodies, which occurs mainly in children and in women with high promiscuity, who resort to more abstract forms of self-pleasure. Other common causes are allergic manifestations after contact with medications to which there is a marked sensitivity. These are most often antiseptic solutions used for prophylactic purposes, contraceptives and cosmetics – soaps, detergents and others. Synthetic fabric underwear and frequently used chemicals in the laundry industry are another common cause of allergic vulvovaginitis. Vulvovaginitis can be a complication after infections with lichen planus, lichen sclerosus atrophicus, aphthosis or psoriasis. The anatomical structure of the female genital tract is often a pretext for the penetration of infections from the external genital tract through the internal to the endometrium of the uterus, and from there to the intraperitoneal space. The main and only protection against invading bacteria in a woman is the natural barrier function of the biochemical flora in the vagina. A major role is played by the highly acidic pH of the female reproductive part of the body, which reaches a value of up to 4 and does not allow the development of external pathogenic bacteria. The central role is played by special acidophilic lactobacilli, which play 95% of the role of a natural defender against external invaders. This natural barrier mechanism can be broken in only two ways! This protective function can be disrupted by means of a massive import of highly pathogenic microorganisms or damage to the lactobacillus flora in the vagina, as a result of some hormonal disorders – estrogen deficiency, which reduces the main substrate of natural bacteria – glycogen. Another way to damage the natural barrier is the long-term use of antibiotics and hormonal preparations, which causes dysbacteriosis and often progresses to the development of candidal vulvovaginitis. NEWS_MORE_BOX The clinical finding is specific. A characteristic vaginal discharge appears, which has a specific color, smell and consistency. With abundant exudation, the secretion flows out and moistens the labia, stings and stains the underwear. There is inflammation of the mucous membrane and swelling in the area of the external labia, burning and severe pain.The diagnosis is made by taking a vaginal discharge and performing a microbiological examination. Observed under a microscope with GRAM or methylene blue staining. The Giemsa staining method is also used. Treatment is carried out using conservative therapy protocols. Topical preparations with clindamycin cream or vaginal tablets with clotrimazole are applied. Oral therapy includes clindamycin, acyclovir, valaacyclovir – according to the viral genesis of the disease, and metronidazole tablets.
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