ABSTRACT
O estudo clínico-epidemiológico das vulvovaginites torna-se importante, tendo em vista a alta incidência de casos nos consultórios ginecológicos - sintomáticos ou não - e o alto grau de recidivas. Os autores questionam se as causas seriam a falta de tratamento, a resistência ao tratamento, ou a constante exposição aos fatores de risco. Uma pesquisa ampla foi realizada na literatura publicada entre 1965 a 1998 no que se refere à inflamação, com descarga vaginal limitada à vulva e vagina, pelos agentes Candida sp., Trichomonas vaginalis e a vaginose bacteriana. Foram estudados os fatores de risco para a infecção vaginal e sua relação com os hábitos alimentares e de higiene, entre outros fatores, das mulheres com quadros crônicos de vulvovaginites. Também foi estudada a importância da abordagem terapêutica adequada, enfatizando a profilaxia de infecções recorrentes e o tratamento dos parceiros sexuais
Subject(s)
Candidiasis, Vulvovaginal/etiology , Candidiasis, Vulvovaginal/physiopathology , Gardnerella vaginalis , Trichomonas vaginalis , VulvovaginitisABSTRACT
Os autores realizam um trabalho de revisão, atualizando os conceitos modernos dos mecanismos imunológicos presentes na candidíase (local e sistêmica). O papel dos linfócitos T, anticorpos, fatores neuroendócrinos e citocininas é discutido. São propostos tratamentos imunomoduladores futuros para esta infecção
Subject(s)
Humans , Candida albicans , Candidiasis, Chronic Mucocutaneous/physiopathology , Candidiasis, Vulvovaginal/physiopathology , Candidiasis/immunology , Candidiasis/therapy , T-Lymphocytes , Antibodies , Immunologic Factors/therapeutic use , ImmunotherapySubject(s)
Humans , Adolescent , Sexually Transmitted Diseases/physiopathology , Sexually Transmitted Diseases/prevention & control , Sexuality , Women , Candidiasis, Vulvovaginal/physiopathology , Chancre , Condylomata Acuminata , Enteritis , Giardiasis/physiopathology , Gonorrhea/physiopathology , Granuloma Inguinale , Hepatitis A , Hepatitis B , Herpes Genitalis , Herpes Labialis , Salmonella Infections/physiopathology , Lice Infestations , Lymphogranuloma Venereum/physiopathology , Molluscum Contagiosum , Scabies , Acquired Immunodeficiency Syndrome/physiopathology , Trichomonas Infections/physiopathology , UrethritisSubject(s)
Humans , Female , Vaginitis/physiopathology , Vaginosis, Bacterial/physiopathology , Candidiasis, Vulvovaginal/diagnosis , Candidiasis, Vulvovaginal/physiopathology , Trichomonas Infections/diagnosis , Trichomonas Infections/physiopathology , Vaginitis/diagnosis , Vaginosis, Bacterial/diagnosisABSTRACT
One of the main causes for women consultation are genital infectious diseases manifested as vaginal discharge. Infection due to Candida species is currently regarded as the second commonest cause of vaginitis in Colombia. Therapy with antibiotics and oral contraceptives, hormone imbalances, physical factors and immunological defects are frequently associated to vulvovaginal candidiasis. For reasons that are not clear many women are colonized but only a small minority develop symptoms, that readily respond to topical intravaginal antifungal agents, and an even smaller number have frequent recurrent symptoms. Despite the fact that symptoms and signs are not specific, pruritus and white discharge are predominant complaints. Experimental studies have shown that 100 yeasts are the minimal inoculum for causing clinical manifestations of infection and that the incubation period is between one and four days. It is also known that for isolation of one colony in solid culture 100 yeatst per ml of vaginal discharge are required, while for direct microscopical observation 100,000 are necesary. Most symptomatic women have positive direct examination while it is exceptionally positive in asymptomatic cases; false negative direct examination is extremely rare in symptomatic patients. Culture is only needed in symptomatic women in whom the direct examination of vaginal discharge is negative and other etiologies...