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| '''For patient information, click [[Bacterial vaginosis (patient information)|here]]''' | | '''For patient information, click [[Bacterial vaginosis (patient information)|here]]''' |
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| | {{Bacterial vaginosis}} |
| | {{CMG}}; {{AE}} {{SaraM}} |
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| {{Infobox_Disease | | {{SK}} Anaerobic vaginosis; Nonspecific vaginitis |
| | Name = {{PAGENAME}}
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| | DiseasesDB =
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| | ICD10 = {{ICD10|B|96||b|95}}, {{ICD10|N|76||n|70}}
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| | ICD9 = {{ICD9|616.1}}
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| | MeshID = D016585
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| {{Bacterial vaginosis}}
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| {{CMG}}
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| ==[[Bacterial vaginosis overview|Overview]]== | | ==[[Bacterial vaginosis overview|Overview]]== |
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| ==[[Bacterial vaginosis pathophysiology|Pathophysiology]]== | | ==[[Bacterial vaginosis pathophysiology|Pathophysiology]]== |
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| ==[[Bacterial vaginosis epidemiology and demographics|Epidemiology & Demographics]]==
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| ==[[Bacterial vaginosis risk factors|Risk Factors]]==
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| ==[[Bacterial vaginosis screening|Screening]]== | | ==[[Bacterial vaginosis causes|Causes]]== |
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| ==[[Bacterial vaginosis causes|Causes]]==
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| ==[[Bacterial vaginosis differential diagnosis|Differentiating Bacterial vaginosis]]==
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| ==[[Bacterial vaginosis natural history|Complications & Prognosis]]==
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| ==Diagnosis== | | ==[[Bacterial vaginosis differential diagnosis|Differentiating Bacterial vaginosis from other Diseases]]== |
| [[Bacterial vaginosis history and symptoms|History and Symptoms]] | [[Bacterial vaginosis physical examination|Physical Examination]] | [[Bacterial vaginosis laboratory tests|Laboratory tests]] | [[Bacterial vaginosis electrocardiogram|Electrocardiogram]] | [[Bacterial vaginosis x ray|X Rays]] | [[Bacterial vaginosis CT|CT]] | [[Bacterial vaginosis MRI|MRI]] [[Bacterial vaginosis echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Bacterial vaginosis other imaging findings|Other images]] | [[Bacterial vaginosis other diagnostic studies|Alternative diagnostics]]
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| ==Treatment== | | ==[[Bacterial vaginosis epidemiology and demographics|Epidemiology and Demographics]]== |
| [[Bacterial vaginosis medical therapy|Medical therapy]] | [[Bacterial vaginosis surgery|Surgical options]] | [[Bacterial vaginosis primary prevention|Primary prevention]] | [[Bacterial vaginosis secondary prevention|Secondary prevention]] | [[Bacterial vaginosis cost-effectiveness of therapy|Financial costs]] | [[Bacterial vaginosis future or investigational therapies|Future therapies]] | |
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| ==Causes== | | ==[[Bacterial vaginosis risk factors|Risk Factors]]== |
| A healthy vagina normally contains many [[microorganisms]], some of the common ones are ''Lactobacillus crispatus'' and ''Lactobacillus jensenii''. ''Lactobacillus'', particularly hydrogen peroxide-producing species, appears to help prevent other vaginal microorganisms from multiplying to a level where they cause symptoms. (Note: ''[[Lactobacillus acidophilus]]'' is not one of the species of ''Lactobacillus'' identified as playing a protective role in vaginal flora.) The microorganisms involved in BV are very diverse, but include ''[[Gardnerella vaginalis]]'', ''[[Mobiluncus]]'', ''[[Bacteroides]]'', and ''[[Mycoplasma]]''. A change in normal bacterial flora including the reduction of lactobacillus, which may be due to the use of antibiotics or pH imbalance, allows more resistant bacteria to gain a foothold and multiply. In turn these produce toxins which affect the body's natural defenses and make re-colonization of healthy bacteria more difficult.
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| Most cases of bacterial vaginosis occur in sexually active women between the ages of 15 and 44, especially after contact with a new partner. [[Condom]]s may provide some protection and there is no evidence that [[spermicide]] increases BV risk. Although BV appears to be associated with [[sexual activity]], there is no clear evidence of sexual transmission.<ref name="Bradshaw2006">{{cite journal | author=Bradshaw CS, Morton AN, Hocking J, ''et al.'' | title=High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence | journal=J Infect Dis | year=2006 | volume=193 | issue=11 | pages=1478–86 }}</ref> Rather, BV is a disordering of the chemical and biological balance of the [[Human flora|normal flora]]. Recent research is exploring the link between sexual partner treatment and eradication of recurrent cases of BV. [[Pregnancy|Pregnant]] women and women with [[sexually transmitted infections]] are especially at risk for getting this infection. Bacterial vaginosis does not usually affect women after [[menopause]]. A 2005 study by researchers at [[Ghent University]] in Belgium showed that subclinical iron deficiency ([[anemia]]) was a strong predictor of bacterial vaginosis in pregnant women. A longitudinal study published in February 2006 in the American Journal of Obstetrics and Gynecology showed a link between psychosocial stress and bacterial vaginosis independent of other risk factors.
| | ==[[Bacterial vaginosis screening|Screening]]== |
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| ==Complications== | | ==[[Bacterial vaginosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| Although previously considered a mere nuisance infection, untreated bacterial vaginosis may cause serious complications, such as increased succeptibility to sexually transmitted infections including HIV, and may present other complications for pregnant women.<ref name="titleSTD Facts - Bacterial Vaginosis (BV)">{{cite web |url=http://www.cdc.gov/std/bv/STDFact-Bacterial-Vaginosis.htm#Complications |title=STD Facts - Bacterial Vaginosis (BV) |accessdate=2007-12-04 |format= |work=}}</ref> It has also been associated with an increase in the development of [[Pelvic inflammatory disease]] (PID) following surgical procedures such as a hysterectomy or an abortion.
| | ==Diagnosis== |
| | [[Bacterial vaginosis Amsel criteria|Amsel Criteria]] | [[Bacterial vaginosis history and symptoms|History and Symptoms]] | [[Bacterial vaginosis physical examination|Physical Examination]] | [[Bacterial vaginosis laboratory findings|Laboratory Findings]] | [[Bacterial vaginosis other imaging findings|Other Imaging Findings]] | [[Bacterial vaginosis other diagnostic studies|Other Diagnostic Studies]] |
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| ==Treatment== | | ==Treatment== |
| Bacterial vaginosis can be treated with [[antibiotic]]s such as [[metronidazole]] and [[clindamycin]]. However, there is a high rate of recurrence.<ref name="Bradshaw2006"/> | | [[Bacterial vaginosis medical therapy|Medical Therapy]] | [[Bacterial vaginosis surgery|Surgery]] | [[Bacterial vaginosis primary prevention|Primary Prevention]] | [[Bacterial vaginosis secondary prevention|Secondary Prevention]] | [[Bacterial vaginosis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Bacterial vaginosis future or investigational therapies|Future or Investigational Therapies]] |
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| Currently, there are very few [[Over-the-counter drug|over the counter]] products that address bacterial vaginosis. A vaginal gel product called RepHresh claims to regulate the pH level. [[Boric acid]] capsules inserted vaginally is considered a home treatment. Lactobacillus supplements may also be used; Fem-dophilus (Jarrow Formulas) is a lactobacillus product which specifically claims to help maintain healthy vaginal flora.<ref name="titleSpecific probiotic strains are effective for genitourinary infections Townsend Letter for Doctors and Patients - Find Articles">{{cite web |url=http://findarticles.com/p/articles/mi_m0ISW/is_280/ai_n16865224 |title=Specific probiotic strains are effective for genitourinary infections Townsend Letter for Doctors and Patients - Find Articles |accessdate=2007-12-04 |format= |work=}}</ref>
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| It should be noted that seeking medical attention is often necessary, because none of the over the counter products can claim to treat an active infection. More importantly, patients often inaccurately diagnose BV as a [[Candidiasis|yeast infection]], and delay proper treatment which may lead to complications.
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| In a [[randomized controlled trial]],<ref name="pmid11127100">{{cite journal |author=Hanson JM, McGregor JA, Hillier SL, ''et al'' |title=Metronidazole for bacterial vaginosis. A comparison of vaginal gel vs. oral therapy |journal=J Reprod Med |volume=45 |issue=11 |pages=889–96 |year=2000 |pmid=11127100 |doi=}}</ref> researchers found the efficacy of 0.75% metronidazole vaginal gel in treating bacterial vaginosis (cure rate 70.7%) was equivalent to that of standard oral metronidazole treatment (cure rate 71%). Treatment with vaginal metronidazole gel was associated with fewer gastrointestinal complaints.
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| ==References== | | ==Case Studies== |
| {{reflist|2}}
| | [[Bacterial vaginosis case study one|Case #1]] |
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| [[de:Bakterielle Vaginose]]
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| [[es:Vaginosis bacteriana]]
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| [[it:Vaginosi]]
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| [[sr:Вагиноза]]
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| [[pl:Bakteryjne zapalenie pochwy]]
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| {{WikiDoc Help Menu}} | | {{WikiDoc Help Menu}} |
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| [[Category:Disease]] | | [[Category:Disease]] |
| | [[Category:Up-To-Date]] |
| [[Category:Gynecology]] | | [[Category:Gynecology]] |
| | [[Category:Emergency medicine]] |
| [[Category:Infectious disease]] | | [[Category:Infectious disease]] |