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This document discusses bacterial vaginosis (BV) caused by Gardnerella vaginalis. It presents a case study of a 28-year-old woman complaining of abnormal vaginal discharge. A Gram stain, pH test, and Affirm VPIII test confirmed BV through the presence of clue cells, a high pH, and detection of G. vaginalis. BV is usually polymicrobial and involves overgrowth of G. vaginalis and other bacteria like Mobiluncus spp. at the expense of normal Lactobacillus flora. G. vaginalis is normally a harmless vaginal resident but can cause infection. Treatment involves oral or topical metronidazole or tinid
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The document discusses several methods for diagnosing bacterial vaginosis:
1. pH of discharge - an elevated pH supports but does not confirm the diagnosis. A low pH rules it out.
2. The whiff test detects a fishy odor when potassium hydroxide is added, which is highly specific.
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the vagina is disrupted and replaced by an overgrowth of certain
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itching, or burning.
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Recommended
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Diagnosisand treatmentofvaginitistaylor09 15-10withdisclosure
This document discusses the diagnosis and treatment of vaginitis, including bacterial vaginosis (BV), vulvovaginal candidiasis, and trichomoniasis. BV is caused by an overgrowth of anaerobic bacteria that normally inhabit the vagina and results in a grayish discharge and abnormal vaginal pH. Risk factors include douching, IUD use, younger age, and multiple sex partners. Diagnosis is based on Amsel's criteria or Gram stain morphology. Treatment involves oral or topical antibiotics like metronidazole or clindamycin.
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This document discusses non-spore forming anaerobic bacteria. It notes that anaerobes outnumber aerobes in the gastrointestinal tract and skin by 1000:1 and 10:1 respectively. It provides examples of common anaerobic genera found in different parts of the body including the mouth, gastrointestinal tract, and vagina. It also discusses characteristics of important anaerobic gram positive and gram negative bacteria and their roles in various infections. Laboratory diagnosis and culturing of anaerobic bacteria is challenging due to their fastidious growth requirements in an oxygen-free environment.
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1. The document discusses several common infections that can affect the female genital tract, including bacterial vaginosis, trichomoniasis, vulvovaginal candidiasis, and cervicitis.
2. It provides details on the causes, symptoms, diagnostic criteria, and treatment recommendations for each infection.
3. The treatment sections emphasize using antibiotics, antifungals, or other medications to address the underlying causes of infection, while considering factors like pregnancy.
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The document discusses the normal vaginal anatomy and microbiota. It describes that the normal vaginal flora is predominantly made up of lactobacillus bacteria which produce lactic acid and hydrogen peroxide. This maintains the normal acidic vaginal pH between 3.8-4.5. Disruptions to the normal microbiota can result in conditions like bacterial vaginosis. The document outlines the causes, symptoms, and treatments for common vaginal infections including bacterial vaginosis, candidiasis, and trichomoniasis. Microscopic examination of vaginal secretions is important for diagnosis of infections.
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Disease: listeriosis.
L. monocytogenes causes a variety of infections in neonates, pregnant women, and immunosuppressed patients.
CNS infections: meningitis, encephalitis, brain abscess, spinal cord infections.
Neonatal:
Early onset: Granulomatosis infantisepticum—in utero infection disseminated systemically that causes stillbirth.
Late onset: Bacterial meningitis.
Food poisoning, bacteremia.
Mode of transmission:
Direct contact: Human gastrointestinal tract, ingestion of contaminated food, such as meat and dairy products.
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Here are the key points in response to the SAQ on non-sporing anaerobes:
1. Non-sporing anaerobic bacteria can be classified as:
- Gram positive cocci (e.g. Peptostreptococcus)
- Gram positive bacilli (e.g. Lactobacillus, Bifidobacterium)
- Gram negative bacilli (e.g. Bacteroides, Fusobacterium, Prevotella)
2. Medically important non-sporing anaerobic bacteria include: Bacteroides fragilis, Prevotella, Porphyromonas, Fusobacterium nucleatum, Pe
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This document discusses altered vaginal discharge (AVD) and common causes. It provides guidance from various medical organizations on evaluating and diagnosing AVD in a clinical setting. The most common causes of AVD are bacterial vaginosis, candidiasis, and trichomoniasis. The document outlines the symptoms, risk factors, diagnostic approach, treatment recommendations, and management considerations for each of these conditions. It emphasizes the importance of correct diagnosis before initiating treatment for AVD.
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Sexton436presentation
- 1. Life is a garden With Gardnerella vaginalis By: Edison Sexton
- 2. Case Q.C. Is a 28 year old woman. Went to doctor complaining about fishy smelling vaginal discharge. Denied soreness or itching Stated several sexual partners including other women Gram stain revealed clue cells, PMNs and a score of 8 on the nugent scale. Vaginal pH of 6
- 3. Case continued “Whiff” test was positive Affirm VPIII was positive for Gardnerella vaginalis. Culture revealed gamma hemolysis on SBA agar and Beta on HBT agar
- 4. Organisms associated with BV Lactobacillus sp. are normal flora Mobiluncus spp. Gardnerella vaginalis Mycoplasma hominis Prevotella spp. Peptostreptococcus spp. Porphyromonas spp. Atopobium vaginae Usually polymicrobial
- 5. BV tests Vaginal discharge >4.5 pH Affirm VPII – Detect Gardnerella vaginalis, Candida albicans and Trichomonas vaginalis. “Whiff” test – Add two drops of 10% KOH – Wait for fishy odor Microscopic - Clue cells - PMNs
- 6. More BV tests Nugent Scoring System – Preliminary identification microscopically – Gives insight to vaginal microbiota prior to culture – Quantitate Lactobacillus morphology – Compare to Gardnerella morphology – More accurate than cultures
- 7. Gardnerella vaginalis Gram-positive coccobacillus (gram variable) Normal flora in 40% of women (in small amounts) Also possible in urine Rarely in blood or wounds
- 8. Growing in lab 5-7% CO2 37°Celsius SBA - pinpoint, gamma hemolysis Human blood bilayer tween agar (HBT) - Beta hemolytic, small, gray, opaque - Similar to V agar Culture rarely done, normally presumptive diagnosis
- 9. Biochemical results Catalase, Oxidase negative Motility negative Esculin hydrolysis negative Acid produced from glucose and maltose
- 10. Biochemical continued -Gamma hemolysis (Beta on HBT) -Positive urease -Rapid antigen testing -Affirm VPIII (DNA hybridization) -16S rRNA gene sequencing
- 11. Treatment Oral or topical Metronidazole or tinidazole Twice daily for seven days Pregnant women at high risk Probiotics
- 12. Sources Amatnieks, Yuri. Fun with microbiology. N.p., 14 Nov. 2010. Web. 27 Apr. 2014. Connie, Mahon, Lehman Donald, and Manuselis George. Textbook of Diagnostic Microbiology. 4th ed. Maryland Heights: Saunders Elsevier, 2011. Print.
- 13. Questions?
Editor's Notes
- Nugent scoring system is a system in which gardnerella, lactobacillus and mobiluncus are all scored for quantity seperately on a scale of 0 to 4. They are then given point values equal to quantity. These values added together indicate BV. 0-3 is normal flora, 4-6 is possible infection and 7-10 is BV.