Female genital tract infections/inflammations

Female genital tract infections/inflammations
Updated: 07/20/2022
© Jun Wang, MD, PhD

General features
  • Virus: Herpes, Human papillomavirus (HPV), molluscum contagiosum virus
  • Bacteria: Gardinerella, Actinomycete (IUD), Syphilis, Gonorrhea, etc
  • Chlamydia trachomatis: Most common STD
  • Fungi: Candida
  • Parasites: Trichomonas
  • Pelvic inflammatory disease
Bartholin cyst
  • Blockage of Bartholin gland duct
  • May be infected by chlamydia, gonorrhea, E. coli, etc
  • Swelling
  • Squamous and urothelial epithelium lined cysts with inflammation
Herpes
  • Associated with HSV1 and HSV2
  • Neonatal herpes associated with vaginal delivery in women with third trimester genital herpes
  • Commonly asymptomatic
  • Painful vesicular lesions until rupture and ulceration, usually heal in a few weeks
  • Pathological findings: Multinucleation, Molding of nuclei, Margining of chromatin, ground glass appearance
  • Diagnosis: Pathological finding and HSV detection (PCR)
Condyloma acuminatum
  • Sexually transmitted infection by human papillomavirus (HPV)
  • Spread through oral, anal and genital sexual contact
  • Vertical transmission and autoinoculation may occur
  • Associated with increased risk of HPV associated neoplasms
  • May have abnormal cervical changes
  • Risk factors: Multiple sexual partners, unprotected intercourse, history of sexually transmitted infections, smoking
  • Clinical presentations: Pearly, filiform, fungating, cauliflower, or plaquelike growth
  • Pathological findings: Koilocytes with raisin-like nuclei and cytoplasmic halo, may have dysplasia or squamous carcinoma
Candida
  • May be asymptomatic, or pruritus, erythematous changes, swollen vulva, dysuria, etc
  • Thick white discharge
  • Associated with immunosuppression, antibiotics, due to changes in vaginal pH, glycogen or flora
  • Pathological findings: acute inflammation and fungal pseudohyphae (Pap or KOH wet mount)
  • Treatment aims to relieve symptoms
Trichomoniasis
  • Caused by Trichomonas vaginalis
  • Increased risk for transmission and acquisition of HIV in women
  • Primary risk factor: Multiple sexual partners
  • Asymptomatic or burning, pruritus, etc
  • Copious yellow-green or gray-white vaginal discharge
  • Strong odor
  • Pathological findings: Pear-shaped, oval, or round cyanophilicprotozoa with four anterior flagella, inflammation
  • Diagnostic approaches
    • Motile trichomonads on saline wet mount
    • Nucleic acid amplification test
    • Rapid antigen or nucleic acid probe test
Bacterial vaginosis
  • Most common vaginal infection for reproductive age women
  • Likely sexually transmitted
  • Alteration of flora due to elevated pH associated with various causes
  • Gardnerella vaginalis and other bacteria
  • Fishy odor, thin, greyish-white vaginal discharge, vulvar irritation
  • Diagnosis: Clinical presentations, wet mount finding of clue cells (squamous cells covered by coccobacilli), Whiff test (fishy odor produced by adding KOH to discharge)
  • Treatment: Symptom relief, prevent postoperative infections, antibiotics (metronidazole, clindamycin, etc
Pelvic inflammatory disease
  • Infectious and inflammatory disorder of the upper female genital tract
  • Common causes: Gonorrhea and chlamydia
  • Chronic inflammation/scarring
  • Risk for infertility or ectopic pregnancy (esp. gonococcal infections)
  • Presumptive diagnosis: sexually active young women, pelvic or lower abdominal pain, evidence of cervical motion, uterine, or adnexal tenderness 
  • Other findings: Scarring of pelvic organs per image studies (thickening of tubules etc), laparoscopic findings of pelvic inflammation (erythematous changes, edema, adehesion, etc), histologic evidence of endometriosis
  • Treatment: Antibiotics (against gonorrhea, chlamydia, etc) 



Back to female genital tract
Back to contents

Comments

Post a Comment

Popular posts from this blog

Contents

Pathology notes Jun Wang, MD, PhD 1. General information Frequently discussed syndromes Terms of dermatology Terms of hematology 2. Primary immunodeficiency disorders 3. Hemodynamic abnormalities Shock Thrombosis and embolism Bleeding disorders 4.  Benign blood cell disorders Anemia Benign white cell disorders 5. Hematopoietic neoplasms Lymphoid neoplasms Myeloid neoplasms Histiocytic neoplasms: Langerhans cell histiocytosis 6. Cardiovascular system Pulmonary hypertension Cardiovascular system tumors 7. Respiratory tract tumors 8. Gastrointestinal tract Congenital disorders Infectious gastroenteritis Oral cavity Esophagus Stomach Intestinal tumors Salivary glands Exocrine pancreas and gallbladder 9. Urinary system Kidney masses Lower urinary tract 10. Male reproductive system 11. Female genital tract 12. Breast 13. Endocrine organs Pituitary gland Adrenal gland Thyroid gland Parathyroid gland Endocrine pancreas M
Read more

Anemia

Anemia Updated: 07/13/2024 © Jun Wang, MD, PhD   General features Decrease in red cell mass Hemoglobin: Levels of hemoglobin in a specific volume of whole blood Hematocrit: Fraction of whole blood composed of red blood cells Red cell count: Quantity of red cell in a specific volume of whole blood Three major groups based on RBC sizes Microcytic Normocytic Macrocytic Three major causes Blood loss: acute or chronic Increased red cell destruction: hemolysis Reduced production: marrow failure due to genetic abnormality or nutritional deficiency Etiology Genetic abnormality Hemoglobinopathies RBC cytoskeletal abomorlities Enzyme abnormalities Fanconi anemia Nutritional deficiencies: iron, VB12, folate, general malnutrition Physical etiologies: trauma, burns, frostbite, prosthetic valves, etc Chronic diseases: chronic infections, neoplasia, autoimmune disorders, kidney or liver diseases, etc Infectious diseases: hepatitis, sepsis , malaria, etc
Read more

Lymphoid neoplasms

Lymphocytic neoplasms Updated: 05/17/2020 © Jun Wang, MD, PhD Terminology Lymphoma : Proliferations forming discrete tissue masses Leukemia : Widespread involvement of the bone marrow and usually the peripheral blood Any "lymphoma" can present with or evolve to a leukemic picture, and any "leukemia" can occasionally present with a mass lesion Other hematology terms Important risk factors Immunodeficiency (primary or secondary) Autoimmune disorders Viruses (HIV, KSHV/HHV8, HTLV-1) H. pylori infection Radiation Chemotherapy Diagnostic approaches Complete history, especially those with possible epidemic characters, such as Burkitt lymphoma CBC, Bone marrow Morphology/immunohistochemistry Immunofluorescence flow cytometry Cytogenetic studies Molecular studies Commonly used markers All lymphomas: CD45 B-cell neoplasms: CD5, CD10, CD19, CD20, CD79a, CD23, bcl2, bcl6, cyclin D1, light chai
Read more