Sharp vaginit – violently proceeding inflammatory process of infectious or noninfectious character affecting a mucous membrane of a vagina. Hyperaemia, an itch and burning in a vagina are signs of a sharp vaginit, plentiful atypical bleach, a dispareuniya, gripes at an urination. Sharp vaginit diagnose according to gynecologic survey, a rn-metriya, microbiological, serological and PTsR-researches of a vaginal secret. Elimination of an etiologichesky factor is conducting in treatment of a sharp vaginit that is reached by means of sanitation of a vagina, anti-inflammatory and antimicrobic therapy with the subsequent normalization of microflora.
Sharp vaginit (a sharp colpitis) – pronounced inflammatory changes mucous a threshold and walls of a vagina, arising in response to an infection, allergens, chemical irritants, influence of high temperature. Among women of reproductive age steadily high incidence of a sharp vaginit with big predisposition to synchronization of pathology and a frequent recurrence is fixed. Sharp vaginit often proceeds in combination with an inflammation of a vulva (vulvovaginit), urethras and necks of a uterus. Duration of a sharp form of a vaginit does not exceed 2 weeks, subsharp – 2 months. Sharp vaginit causes constant and considerable discomfort, breaks sexual life, can promote involvement in an inflammation of other reproductive organs (a uterus, ovaries), and at pregnancy – to pre-natal infection and formation of defects of a fruit, pregnancy not incubation.
Reasons of a sharp vaginit
In development of a sharp vaginit the crucial role belongs to an infectious factor - to bacteria, protozoa, viruses, mushrooms. In most cases as etioagent the alien microorganisms which got from the outside at sexual contact (STD) or from other centers of an infection act (for example, tubercular). As the contributing moment serves violation of a normal biotope of a vagina - the excessive growth of saprofitny microflora and finding of virulence by it against the background of decrease in a caption of lactobacilli. It leads to shift of pH in the alkaline party, to change of structure and immune properties of a vaginal secret.
Development of a sharp vaginit is promoted by decrease in the general and local resistance (against the background of reception of glucocorticoids, the COOK and antibiotics, stresses, hypovitaminosis), violation of integrity of an epitelialny cover of a vagina (a trauma foreign matters, at abortion, RDV, hysteroscopy, installation of Naval Forces), a hormonal imbalance (a gipoestrogeniye, a hypothyroidism, a menopause, pregnancy), exchange violations (diabetes). Changes of structure of a vagina (omission of walls, a gaping of a sexual crack) and vascular and trophic violations mucous genitals support decrease in protective properties of vaginal slime.
To provoke sharp vaginit frequent change of sexual partners, the unprotected sexual intercourse, incorrect personal and intimate hygiene, influence of chemical, thermal and allergic factors (burns, wearing synthetic linen, intolerance of condoms, spermitsid, anti-septic tanks, means of intimate hygiene, fabrics conditioners) can. Sharp vaginit at girls it is possible at hematogenic spread of an infection from other centers (for example, at scarlet fever), diathesis, helminthoses, insufficient hygiene of genitals, hit of foreign matters in a vagina.
Classification of a sharp vaginit
Sharp vaginit can carry infectious (bacterial, fungal, protozoan, virus, mixed) and noninfectious (allergic, chemical, thermal) genesis. Infectious inflammations of a vagina as the activator which caused them share on specific (gonorrheal, syphilitic, trikhomonadny, chlamydial, mikoplazmenny, tubercular, etc.) and nonspecific.
Nonspecific (aerobic) sharp vaginita usually are caused by enterobakteriya (E. coli, Enterobacter spp., Enterococcus spp., Proteus mirabilis, etc.), streptococci and stafilokokka (Str. pyogenes., Staph.aureus), difteroidam. The most frequent provoker of fungal sharp vaginit (vaginal candidiasis) are drozhzhepodobny mushrooms of the sort Candida, virus – causative agents of genital herpes (HSV-2), a human papillomavirus infection. The mixed etiologichesky forms of a sharp vaginit can meet: protozoan and bacterial, fungal and bacterial, fungal and allergic, etc.
Depending on the preceding factor in gynecology allocate postabortion, postnatal, postoperative and allergic sharp vaginita. As vaginal exudate sharp vaginita classify on serous, serous and purulent, gangrenous; on the nature of changes of a mucous membrane – on simple, makulezny, granulezny. Proceeding from age of patients, distinguish sharp vaginita of girls, women of the reproductive and menopausal period.
Symptoms of a sharp vaginit
Various forms of a sharp vaginit are followed by rough manifestations and a rapid current, are quite often combined with vulvity, uretrity, endotservitsity. Patients show complaints to a steady itch and burning in a vagina and genitalia, pains at the sexual intercourse and gripes at an urination, emergence of plentiful uncharacteristic is more white from a genital tract (with pus impurity, sometimes than blood or an unpleasant smell). Hyperaemia, hypostasis and tendency to bleeding mucous a threshold and walls of a vagina is found, at heavy episodes - a deskvamation of an epithelium, an erosion and ulcer.
Sharp trikhomonadny vaginit differs in emergence of a large number of foamy allocations of mucopurulent character with a fetid smell, when involving a neck of a uterus – a symptom of "a strawberry tserviks". Are characteristic of a gonorrheal sharp vaginit plentiful dense putreform bleach, for syphilitic - ulcer damage of genitalia and a vagina. Nonspecific vaginit is followed by noticeable flavovirent allocations. At a kandidozny sharp vaginit grayish-white curdled, flaked allocations and raids on walls and a threshold of a vagina, a vulva erosion are noted.
At a herpetic sharp vaginit painful sores and various damages of a mucous membrane are defined, at pappilomatozny - painful warts of light or violet color in a vagina, on a vulva, in a groin. Allergic vaginit can proceed against the background of other displays of an allergy - hay fever, asthma, atopic dermatitis.
Uncured sharp vaginit leads to chronic recidivous inflammatory processes of a reproductive path and uric ways, during pregnancy poses a threat of infection of a fruit and amniotic waters (horioamnionit), a premature rupture of covers of a fetal bubble and not incubation, development of a postnatal endometritis, pneumonia of the newborn, infertility at women.
Diagnostics of a sharp vaginit
Diagnostics of a sharp vaginit is based on data of clinical laboratory researches - gynecologic survey, screening tests (rn-metriya), microscopy of the native or painted on Gram vaginal dab, the cultural analysis of the separated from a vagina, an urethra and tservikalny channel, PTsR and serological methods (IFA, mutual fund, the REEF).
At a nonspecific sharp vaginit of a bakterioskopicheska a large number of Le (> 10), slushchenny cages of an epithelium (10 and more), plentiful + and gr-microflora comes to light. Increase in pH of a vaginal secret> 6,5 is indicative. By means of the bacteriological analysis specific identification of activators of sharp vaginit, quality and quantitative standard of a condition of a vaginal biotope, sensitivity to antimicrobic medicines is carried out.
Data of serodiagnosis at a sharp vaginit help to define a caption of highly specific antibodies of IgM, IgG and IgA to anti-genes of the activator and a stage of infectious process. The increased concentration of IgE serves as a marker of the allergic nature of a sharp vaginit. At suspicion of syphilis specific serological treponemny reactions are applied. PTsR gives the chance of establishment of a wide range of activators in one clinical sample – creations of "the microbiological passport" of the patient. Differential diagnostics is performed between various etiologichesky forms of a colpitis, and also a sharp vaginit and a bacterial vaginosis.
Treatment of a sharp vaginit
Treatment of a sharp vaginit is carried out by the gynecologist in a complex, taking into account an etiology of an inflammation and includes local sanitation of a vagina and vulva, system etiotropny therapy, normalization of vaginal microflora. In certain cases parallel treatment of the sexual partner is required.
Etiotropny (antibacterial, antimikotichesky, anti-virus) medicines can locally be applied - vaginalno (in the form of candles, balls, capsules, cream) and is system - orally and intramuscularly. At a bacterial sharp vaginit antibiotics are appointed taking into account sensitivity to them the allocated activator: at syphilitic penicillin, macroleads, tsefalosporina are shown; gonorrheal - penicillin, tetratsiklina, ftorkhinolona inside and intramuscularly. At chlamydial, mikoplazmenny and ureaplazmenny sharp vaginita are effective , , .
In case of a nonspecific sharp vaginit happens local application of antiseptic vaginal suppositories and ointments, complex medicines, disinfecting solutions enough (hydroxymethylquinoxalinedioxide, a miramistin), trays to Furacilin, potassium permanganate, broths of officinal herbs. At a kandidozny sharp vaginit antimycotics in the form of vaginal candles and cream (, , ), local nonspecific means are used ( sodium), it is orally appointed . At the expressed itch the desensibilizing and sedative medicines, kortikosteroidny ointments are shown. At trichomoniasis nitroimidazoles are effective (orally and locally). Herpetic vaginit demands application of anti-virus means inside, candles, tampons with ointments (an acyclovir, ). For normalization of a biocenosis of intestines and a vagina appoint eubiotik.
During a course of therapy it is necessary to follow rules of hygiene, sexual abstinence and a diet with an exception sharp, salty, smoked and fat, restriction of sweet. The result of treatment is confirmed by laboratory indicators of a normotsenoz. Prevention of a sharp vaginit comes down to formation of the correct hygienic skills and healthy habits, an exception of casual sexual communications, restriction of use of tampons, means for intimate hygiene with fragrances, synthetic and close underwear.