Aerobic vaginitis: no longer a stranger

摘要: Aerobic vaginitis (AV) is the name given in 2002 to a vaginal infectious entity which was not recognized as such before. It characterized by abnormal (dysbiotic) microflora containing aerobic, enteric bacteria, variable levels of inflammation and deficient epithelial maturation. Although AV bacterial vaginosis (BV) share some characteristics, diminished number or absence lactobacilli, increased discharge (fishy smelling BV, while severe forms AV, foul, rather rotten smell may be present) pH (often more pronounced AV), there are also striking differences between two. There no women with whereas vagina often appears red edematous, even display small erosions ulcerations. The color BV usually whitish gray watery consistency, it yellow green thick mucoid. Women do have dyspareunia, do. Finally, microscopic appearance differs various aspects, presence leucocytes parabasal immature cells granular aspect microflora, typical BV. Despite all these differences, distinction many former studies, leading incomplete imprecise diagnostic workouts erroneous management patients both clinical research settings. prevalence ranges 7 12%, therefore less prevalent than still largely undiagnosed, researchers clinicians increasingly take into account cause symptomatic vaginitis. can co-occur other entities, candidiasis. associated sexually transmitted infections (such human papilloma virus, immunodeficiency Trichomonas vaginalis Chlamydia trachomatis), chorioamnionitis, fetal infection, preterm birth cervical dysplasia. Many possible pathological associations currently under investigation. diagnosis made using wet mount microscopy, ideally phase contrast. An score calculated, according to: lactobacillary grade, inflammation, proportion toxic leucocytes, characteristics cells. To circumvent hurdle investigation, groups begun develop nucleic-acid-based enzymatic tests, but detailed information obtained contrast microscopy irreplaceable. best treatment yet fully determined, must tailored findings patient's needs. role for local estrogen therapy, corticosteroids, antimicrobials probiotics. Further will reveal precise data on diagnosis, pathogenesis, prevention.