[Pelvic inflammatory disease]. / La malattia infiammatoria pelvica.

At present, PID is considered to be the most severe gynecological infection of young women as well as one of the most important problems of public health involving high social and economical costs. There are two pathogenetic aspects of PID. The primary form results from an ascending infection sustained by the microbic flora of the inferior genital tract, subsequently involving its higher anatomical districts. The secondary form derives from the pelvic diffusion of microorganism primarily involved in extra-genital infections. The analysis of the epidemiological aspects of the disease identifies in the sexual habits, the contraceptive procedures as well as the invasive instrumental practices (iatrogenic factors) the risk factors of the disease. PID has a multimicrobial origin based on a complex interplay between synergic infectious agents, vectors of etiological factors, interferon-gamma and intrauterine devices. The anatomopathological aspects of PID, including Fitz-Hugh-Curtis syndrome are discussed. The literature concerning the diagnosis and the therapy of the disease is extensively analyzed.

[Recurrent vaginitis]. / Le vaginiti recidivanti.

Vaginitis is one of the most frequent infections of the female genital system and, in the United States, represents the main reason for gynecological consultation. Candida albicans, Trichomonas vaginalis and Gardnerella vaginalis are responsible for 90% of cases of vaginal phlogosis. It has been calculated that a percentage varying between 5% and 40% of the female population will suffer, at least once in their lifetime, from an episode of vaginal candidosis. The re-appearance of symptoms after suspension of the antimycotic therapy still represents an unsolved and obscure problem from the etiopathogenetic point of view. The incidence of recurrences in women suffering from various forms of vaginal candidosis, according to the Authors, is between 5% and 25%. Considering the uncertainties existing regarding the clinical and etiopathogenetic definition of recurrent vaginitis we carried out a perspective study, at the General Out-patient Department of the II Obstetrical and Gynecological Clinic of "La Sapienza" Rome University in collaboration with the Bacteriological Laboratory of the III Medical Clinic of "La Sapienza" Rome University, on a group of 60 women suffering from recurrent vaginitis. We included in the study in the period 1 October 1987 - 30 September 1988 60 women reporting to the General Out-Patient Department of the II Obstetrical and Gynecological Clinic of the "La Sapienza" Rome University. These patients complained about the appearance of a leukorrhea or a leukoxanthorrhea in combination with at least one of the following symptoms: burning sensation; itch; dyspareunia; dysuria; recurring cystitis. All the women reported in their case histories having suffered from at least three episodes of recurrent vaginal candidosis in the previous twelve months. Diagnosis had been established on the basis of fresh microscopic examination with determination of the vaginal pH on the occasion of the first episode only; whereas clinical examination only was undertaken on the occasion of the subsequent ones. In 30% of patients (or 18 cases) the diagnosis of the subsequent episodes was "telephonic". In all cases, at each episode, a local therapy with antimycotic drugs had been prescribed. Following the introduction of a sterile speculum sterile swabs were used to remove 2 samples of the fluid present at the level of the posterior vaginal fornix. The first swab was placed in a test-tube containing 2 ml of prereduced transport broth (brain-heart infusion broth oxoid) for the successive aerobe and anaerobe cultures.(ABSTRACT TRUNCATED AT 400 WORDS)