Pus discharge (crviitis/urethritis) in a female caused by
(Chlamydia): (144-45- Dutta Gynae 6th edition; 123. 160 161 -Dutta Gynae 6th)CHLAMYDIAL INFECTIONS - The infection is mostly localized in the urethra, Bartholins gland and cervix* Mucopurulent cervical discharge, cervical oedema, cervical ectopy cervical friabilityComplication - Urethritis and bartholinitis are manifested by dysuria and purulent discharge, chlamydial cervicitis spreads upwards to produce endometritis and salpingitis.Gardnella (Bacterial) Vaginosis - Polymicrobial infectionCaused by Gard nerella vaginalis (Haermophilus vaginalis). The present concept is that long with G. vaginalis anaerobic organism such as Bacterioids species. Peptococcus species, mobiluncus and Mycoplasma hominis act synergistically to cause vaginal infection* Characterized by white milky (creamy) non viscous discharge adherent to vaginal wall* Fishy odour when mixed with 10% KOH* Presence of Clue cells - the epithelial cells have Puzzy border due to adherence of bacteriaAcute cervicitis - responsible organism are ryogenicAerobic(i) Gram positive organisms are. Staphylococcus(ii) Gram negative are - E.coli, pseudomonas, Klebsiella, N.gonnorhoeaeAnaerobes(i) Gram positive are - Streptococucus. Cl.welchii Cl.tetani(ii) Gram negative are mainly bacteroides group of which Bacteroides fragilisOther common pathogens are: Gonococcus, Chlamydia trachomatis, trichomona, bacterial vaginosis, mycoplasma and HP V. The first one being less common nowdaysClinical Features - Cervix is tender on touch or movements oedematous and congested. Mucopurulent discharge is seen escaping out through the external osChronic cervicitis - potential reservoir for N-gonorrhoea, Chlamydia. HPV, mycoplasma and bacterial vaginosisMucopurulent is the predominant symptomsCandida Vaginitis (Moniliasis) caused by Candida albicans* Pruritis is out of proportion to the discharge* Discharge is thick, curdy white and in flakes (cottage cheese type) often adherent to the vaginal wall
Papilloma
Chlamydia
Candida
Bacterial Vaginosis
Miscellaneous (Gynae)