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Author: Dr Carolina González, Dermatology Registrar, University of Santiago de Chile, Santiago, Chile. DermNet NZ Editor in Chief: Adjunct A/Prof Dr Amanda Oakley; Dermatologist, Hamilton, New Zealand. January 2018.
The term 'vaginitis' means an inflamed vagina; the term is loosely used to refer to any vaginal condition that results in a vaginal discharge, whether due to infectious or non-infectious causes.
Aerobic vaginitis is characterised by:
Aerobic vaginitis was first characterised by Donders et al in 2002. Desquamative inflammatory vaginitis is a severe form of aerobic vaginitis [1,2].
Aerobic vaginitis may affect adult women of any age, whether pre- or post-menopause. The prevalence of aerobic vaginitis has been estimated in different populations as being present in 5–13% of asymptomatic women and affecting a greater proportion of women with vaginal symptoms. It may be less prevalent among pregnant women.
The risk factors for infection are under evaluation.
The cause of aerobic vaginitis is unknown. Aerobic vaginitis is a form of dysbiosis, a disturbance in the ecology of aerobic micro-organisms that reside in the vaginal microflora (the microbiome). These microorganisms include:
It is unclear whether the primary cause of aerobic vaginitis is pathogenic organisms, lack of lactobacilli, immune dysregulation and pro-inflammatory cytokines, or insufficient oestrogen in the vaginal mucosa (atrophic vulvovaginitis) .
The symptoms of aerobic vaginitis can fluctuate over a long period of time. They include :
Examination findings may include:
Aerobic vaginitis has been associated with :
The diagnosis of aerobic vaginitis is confirmed by wet–mount microscopy of fresh vaginal fluid, ideally using phase contrast. The aerobic vaginitis score is graded as 0–3 (absent), 3–4 (mild), 5–6 (moderate), and 6–10 (severe). The aerobic vaginitis score is calculated from the :
Various advanced diagnostic methods are being established for aerobic vaginitis.
Phase contrast microscopy of aerobic vaginitis
*Credit: Pedro Vieira Baptista
The treatment of aerobic vaginitis depends on the microscopic findings and patient needs .
Expert advice should be sought from a medical microbiologist in pregnant women with aerobic vaginitis.
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