Medicine an Surgery notes

Apr 24th, 2015
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GENITAL TRACT INFECTIONSLower genital tract disordersDefinition:Infections and other inflammatory disorders affecting the vaginal mucosa and sometimes the vulva, commonly producing a vaginal discharge.Age must be considered when attempting to determine the etiology of vaginal or vulvar symptoms.In newborns, a sterile mucoid vulvovaginal discharge may be secondary to maternal estrogens transferred before birth; the discharge subsides about 2 wk after birth. A small amount of bleeding may result from this estrogen withdrawal.In children, vulvitis is most commonly due to infection by Escherichia coli; streptococci, staphylococci, and Candida sp are less common causes. Occasionally, pinworms cause infection. If Neisseria gonorrhoeae is found on culture, sexual abuse is confirmed. Chemicals in bubble baths or soaps may cause irritation When a discharge is present, especially with blood, a foreign body must be ruled out. Poor hygiene and fingering, a practice common to girls aged 2 to 6 yr, contribute to infection. A normal physiologic discharge may develop or increase as a child approaches menarche because estrogen production increases.In women of reproductive age, a normal physiologic discharge may be mistaken for an infection. The discharge is commonly milky white or mucoid, arising from the cervix or vagina as an epithelial transudate.Lactobacillus and Corynebacterium sp are usually present. Colonization of the vagina by Lactobacillus sp keeps the pH normal

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