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1. inflammation of any sheathlike structure.
inflammation of the vagina; called also colpitis
. Inflammation of the vaginal mucosa is invariably related to a disturbance in normal vaginal physiology. A healthy vagina depends on (1) normal estrogen secretion to maintain a thick squamous epithelium containing glycogen and (2) chemical reactions beginning with the glycogen thus available. The glycogen stimulates the growth of lactobacilli, which are beneficial normal vaginal flora that metabolize glycogen to form lactic acid. The lactic acid maintains vaginal acidity at a pH of 4.0 to 4.5.
Tampons, condoms, neglected diaphragms, and irritating douches or deodorant sprays can upset the vagina's environmental balance and produce abnormal vaginal discharge. Hyperglycemia and antibiotics can also disturb this balance. However, infectious agents are the most common cause of vaginitis; these include Trichomonas
(See also bacterial vaginosis
.) Characteristics of these types of vaginitis and medical treatment and nursing intervention are summarized in the accompanying table.
Patient Education. Patients with infectious vaginitis need to know the purpose and importance of diagnostic testing and examination to verify a diagnosis, the specific type of infection or infections thus identified, and changes that may need to be made in their sexual activity to avoid reinfection. Sexual intercourse is avoided while active symptoms are present. Concurrent treatment of the partner is often necessary to avoid cyclic reinfection of one another. Condoms are encouraged because they can provide both the man and woman with some protection against sexually transmitted diseases.
In regard to prescribed treatment, the patient should be instructed to take all of the medication exactly as prescribed; a follow-up examination and testing may be necessary. If the woman has a cervical Pap smear done while she has vaginitis, there may be an abnormal test result.
atrophic vaginitis with ulceration and exfoliation of the mucosa result in adhesions of the membranes; opposite surfaces may adhere to each other, causing obliteration of the vaginal canal. Called also senile vaginitis
atrophic vaginitis vaginitis occurring in postmenopausal women, associated with estrogen deficiency. The two most common types are senile vulvovaginitis and adhesive vaginitis.
desquamative inflammatory vaginitis a form resembling atrophic vaginitis but affecting women with normal estrogen levels.
emphysematous vaginitis inflammation of the vagina and adjacent cervix, characterized by numerous asymptomatic, gas-filled cystlike lesions.
A yeast infection caused by Candida albicans
Symptoms include a thick, curdlike adherent discharge; itching; dysuria; and dyspareunia. The vulva and vagina are bright red. History usually reveals one or more risk factors: use of oral contraceptives or broad-spectrum antibiotics; immune defects; diabetes mellitus; pregnancy; or frequent douching. Diagnosis is established by the presence of hyphe and buds on a wet smear treated with 10% potassium solution, a pH of 4.5 or less, and/or of growth of culture on Nickerson's or Sabouraud's media. Treatment may include the use of topical or oral antifungal agents, or both. Oral fluconazole, given once, or topical applications of miconazole, clotrimazole, butoconazole, or terconazole, given 3 to 7 days, promptly relieve symptoms. Recurrence of symptoms after treatment is often due to presence of candida species other than C. albicans, presence of a mixed infection, or reinfection. Either use of a different agent or a longer course of treatment (14 to 21 days) is indicated, as well as testing for hyperglycemia. Synonym: moniliasis