Trichomonas vaginitis is a sexually transmitted disease by Trichomonas vaginalis infection especially in adults that is significantly associated with preterm delivery, premature rupture of membrane and low-birth-weight neonates. Although neonatal infection is rare, a vertical transmission might substantially occur by direct contact of protozoal infection. The reported clinical manifestation of trichomoniasis is purulent vaginal discharge in only severely infected neonates. I experienced a case of virulent neonatal Trichomonas vaginitis which was confirmed by vaginal wet mount examination in a neonate born full-term, complaining of excessive purulent vaginal discharge, with no perinatal complication of premature rupture of membrane or low-birth-weight. The patient had complete resolution of symptom after the administration of metronidazole, thus I report this case along with a brief review of literatures.
Adult ; Humans ; Infant, Newborn ; Membranes ; Metronidazole ; Rupture ; Sexually Transmitted Diseases ; Trichomonas vaginalis ; Trichomonas Vaginitis* ; Trichomonas* ; Vaginal Discharge

Trichomoniasis is a sexually transmitted disease by Trichomonas vaginalis infection that may be associated with preterm delivery and low birth weight in the newborn infants. T. vaginalis may be transmitted to neonates during passage through an infected birth canal and neonatal infection is usually self-limiting course, but rare cases of symptomatic neonatal infection such as vaginitis, urinary tract infection and respiratory infection have been reported. We experienced a case of symptomatic neonatal trichomoniasis which was confirmed by wet mount examination of vaginal discharge and urine specimens in premature baby with intrauterine growth retardation. The patient had complete resolution of symptoms such as vaginal discharge and pyuria after treatment with ornidazole (tiberalR). We report this case with a brief review of the related literatures.
Fetal Growth Retardation ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Ornidazole ; Parturition ; Pyuria ; Sexually Transmitted Diseases ; Trichomonas vaginalis ; Urinary Tract Infections ; Vaginal Discharge ; Vaginitis

OBJECTIVE: The aim of this study was to analize the biologic and molecular genetic characteristics of Lactobacillus spp. isolated from vagina of Korean healthy women and to perform a pilot clinical study on the treatment of vaginitis using the best Lactobacillus strain KLB 46. METHODS: Vaginal specimens were obtained from 205 Korean women with healthy vaginal ecosystems. 155 lactobacillus strains were used for catalase test, cell surface hydrophobicity (CSH) test and antimicrobial activity test. Also we identified the species prevalence by PCR-RFLP analysis of 16S rDNA gene and performed the minimal inhibitory concentrationtest using14 antibiotics to determine their patterns of antibiotic susceptibility. A pilot clinical trial of 8 bacterial vaginosis, 1 trichomonas vaginitis and 6 atrophic vaginitis using Lactobacillus crispatus KLB 46 was done by vaginal instillation (10(10)-10(11) cells/mL). RESULTS: 155 lactobacilli strains were isolated and all isolates showed high CSH and 61% of the isolates had higher CSH. L. acidophilus and L. crispatus were the most prevalent species by PCR-RFLP analysis of their 16S rDNA gene. And PCR-RFLP analysis suggested that KLB 46 was L. crispatus. The clinical study showed that the vaginal epithelial adherence rate was high as 77% for bacterial vaginosis and 33.3% for atrophic vaginitis. CONCLUSION: The predominating lactobacilli were L. crispatus and L. acidophilus in Korean women's vaginas. Although further study would be needed, L. crispatus KLB 46 is a good candidate of suitable probiotics for bacterial vaginosis.
Administration, Intravaginal ; Anti-Bacterial Agents ; Atrophic Vaginitis ; Catalase ; DNA, Ribosomal ; Ecosystem ; Female ; Humans ; Hydrophobic and Hydrophilic Interactions ; Lactobacillus* ; Molecular Biology* ; Prevalence ; Probiotics ; Trichomonas Vaginitis ; Vagina* ; Vaginitis* ; Vaginosis, Bacterial

Three common vaginal infections are bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomonas vaginitis (TV). However their symptoms and signs are similar and atypical and other non-infectious vaginal inflammations will be the causes of identical symptoms. Hence accurate diagnosis is the first step in management of vaginitis and then appropriate therapy should be conducted. Metronidazole is the drug of choice for the treatment of BV and TV. Topical or oral azole antifungal regimens are highly effective in reliving symptoms of VVC. Physicians who treat the woman having vaginitis should consider the fact that the disease may be chronic, frequent and recurrent due to antibiotics abuse and over the counter antimycotic agents. Also predisposing factors must be removed before medical therapy.
Anti-Bacterial Agents ; Candidiasis, Vulvovaginal ; Causality ; Danazol ; Diagnosis ; Female ; Humans ; Inflammation ; Metronidazole ; Trichomonas Vaginitis ; Vaginitis* ; Vaginosis, Bacterial

Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increased vaginal colonization by harmful microorganisms (e.g., Enterobacter, Escherichia coli, Candida, and Gardnerella). Probiotics positively effects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginal microbiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections (e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article, we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness of probiotics in the treatment and prevention of BV and VVC.
Candida ; Candidiasis, Vulvovaginal ; Colon ; Enterobacter ; Escherichia coli ; Estrogens ; Female ; Glycogen ; Humans ; Hydrogen-Ion Concentration ; Lactic Acid ; Lactobacillus ; Microbiota ; Odors ; Postmenopause ; Premenopause ; Probiotics* ; Progesterone ; Vagina ; Vaginal Discharge ; Vaginal Diseases ; Vaginosis, Bacterial

BACKGROUND: Infectious vaginitis is caused primarily by three different groups of microbial pathogens (Trichomonas vaginalis, Candida spp., and Gardnerella vaginalis). The objective of this study was to compare the Affirm VPIII assay using a DNA hybridization technique with the Papanicolaou (Pap) smear test and the Gram stain in the detection and identification of these three organisms. METHODS: A total of 300 vaginal samples were collected from women that were either symptomatic for vaginitis or asymptomatic women that were being seen for routine obstetric or gynecological care. The presence of T. vaginalis, Candida spp., and G. vaginalis was evaluated by using the Affirm VIII assay (Becton Dickinson, USA), Pap smear test, and Gram stain method, respectively. RESULTS: With the Affirm VPIII assay, 1 (0.3%) patient tested positive for T. vaginalis, 99 (33.0%) patients were positive for G. vaginalis, and 18 (6.0%) were positive for Candida spp. The detection rates of Trichomonas infection, bacterial vaginosis and candidiasis by the Pap smear test and Gram stain method were 0.7% versus 0%, 16.3% versus 35.7%, and 1.7% versus 9.7%, respectively. The differences between the detection rates of the above three organisms between the Pap smear test and the Gram stain method were statistically significant (p<0.05). CONCLUSION: The Affirm VPIII assay was more sensitive than the Pap smear test and more specific than the Gram stain method for the detection and identification of these three organisms. In addition, the results of the Affirm VPIII assay are quick to obtain and are simple and easy to interpret.
Candida ; Candidiasis ; Chimera ; DNA ; Female ; Gardnerella ; Gardnerella vaginalis ; Humans ; Trichomonas ; Trichomonas Infections ; Trichomonas vaginalis ; Vaginal Smears ; Vaginitis ; Vaginosis, Bacterial

Because sex hormones influence the lower urinary tract, menopause can cause several urinary diseases including overactive bladder, stress urinary incontinence and recurrent urinary tract infection. However, the results of many clinical studies have indicated that menopausal hormone replacement therapy is not effective for the treatment of previous diseases, especially via the oral route. Although estrogen vaginal cream or pessary is an effective treatment for overactive bladders and can prevent recurrent urinary tract infection, its beneficial effects only last for the duration of the treatment. If patients with previous mentioned urologic disease have other local symptoms and conditions, such as atrophic vaginitis and dyspareunia, local estrogen replacement therapy will be helpful in relieving the local symptoms. However, the potential for breast cancer or return of withdrawal of bleeding, patient's age, adverse effect of systemic administration, estrogen-progesterone combination therapy, and effectiveness among other treatment modalities must be considered before a treatment decision can be made. In this article, we will review the current issues on the relationship among urinary tract and sex hormone and menopause, and the effectiveness of menopausal hormone replacement therapy for the treatment of overactive bladders, stress urinary tract incontinence and recurrent urinary tract infection.
Atrophic Vaginitis ; Breast Neoplasms ; Dyspareunia ; Estrogen Replacement Therapy ; Estrogens ; Female ; Gonadal Steroid Hormones ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Menopause ; Pessaries ; Urinary Bladder ; Urinary Bladder, Overactive ; Urinary Incontinence ; Urinary Tract ; Urinary Tract Infections ; Urologic Diseases ; Vaginal Creams, Foams, and Jellies

Female ; Humans ; Vaginal Diseases ; Adenocarcinoma ; Stomach ; Hyperplasia ; Vaginal Neoplasms/surgery*

This purpose of this study was to establish a new standard for the surgical management of female genital fistula in Korea. From January 1992 to October 2001, 117 patients with female genital fistula who were admitted to the departments of obstetrics and gynecology, urology and general surgery were analyzed. Nine patients with congenital etiologies and 48 patients who were treated conservatively were excluded. The relationships between surgical outcome and the cause of fistula, the location of fistula, and the various surgical methods were analyzed. In spite of appropriate surgical treatment, fistulas due to cervix cancer management had the worst prognosis. In terms of location, fistula recurrence after surgical repair was most common in the bladder fundus and base. The transvaginal and transrectal approaches are suitable for fistulas located in the lower vagina. The transabdominal approach is appropriate for fistulas located in the functional portions such as the bladder and ureter, for fistulas which are difficult to expose surgically by either the vaginal or rectal approach, or in cases with severe adhesions. In cases of cervix cancer, extra care should be taken during surgical expiration or definitive radiotherapy, especially when the areas involved are the bladder fundus and base. The nature of the surgical approach should be decided by the location of the fistula, the functional importance of the area, and the degree of surgical exposure during the corrective procedures.
Adolescent ; Adult ; Child ; Female ; Human ; Korea ; Middle Age ; Rectovaginal Fistula/surgery ; Treatment Outcome ; Urinary Fistula/surgery ; Vaginal Fistula/*surgery ; Vesicovaginal Fistula/surgery

Vaginitis is one of the most common disease in gynecologic field in recent days. About 90% of these patients suffer from the infection of the vagina caused by Gardnerella vaginalis, Candida, or Trichomonas, either alone or in combination. For the effective diagnosis and management, it is essential to get an accurate identification of the causative agent. Applying simple and easy diagnostic methods such as pH of vaginal discharge, amine test and microscopic examination of wet mount preparation of normal saline and 10% KOH to 549 cases of randomly selected patients visiting Out-patient Department of Obstetrics and Gynecology of Yeungnam University Hospital through May 1st to Sept. 31st, 1987, the following results were obtained. 1. In the Gardnerella vaginitis vaginal pH was more than 5.0 in 81.0% of total cases, positive amine test in 62.8%, decreased lactobacilli in 77.4% & decreased WBC counts in 70.1%, In the Trichomonas vaginitis vaginal pH more than 5.0 was noted in 93.3% of the cases, negative amine test in 90%, decreased showed vaginal pH of 3.0~4.0 in 83.2%, negative amine test in 90%, decreased lactobacilli in 90% & increased WBC counts in 93.3%, whereas Candida vaginitis and normal groups showed vaginal pH of 3.0~4.0 in 83.2%, negative amine test in 100%, normal distribution of lactobacilli in 89.7%, normal WBC counts in 72.4%. 2. The accuracy rates of physical diagnosis by wet mount preparation of normal saline and 10% KOH revealed 26.3%, 47.5%, 70.0% in Gardnerella vaginitis, Candida vaginitis, and Trichomonas vaginitis, respectively. The vaginal pH and amine test showed 83.2% of accuracy rate in Candida vaginitis group, 60.6% in Gardnerella vaginitis group and 83.3% in Trichomonas vaginitis group. 3. In 23 cases of Gardnerella vaginitis showing vaginal pH of 3.0 or 4.0 and positive amine test, the clue cells were observed in 10% or less in 12 cases, 30% in 5 cases, 50% in 4 cases and 50% or more in 2 cases. In summary vaginal pH and amine test could be useful in screening and differentiating the different types of infectious vaginitis. Furthermore by adding microscopic examination of normal saline and 10% KOH wet mount preparation to them, they not only could obtain higher diagnostic accuracy rate but would be more valuable in selecting the patients requiring cultures to confirm the diagnoses.
Candida ; Diagnosis ; Gardnerella ; Gardnerella vaginalis ; Gynecology ; Humans ; Hydrogen-Ion Concentration* ; Mass Screening ; Obstetrics ; Outpatients ; Trichomonas ; Trichomonas Vaginitis ; Vagina ; Vaginal Discharge* ; Vaginitis*