Vaginal dysfunction: evaluation of two methodologies
DOI:
https://doi.org/10.35954/SM2018.37.2.4Keywords:
Candidiasis, Vulvovaginal, Vaginal Diseases, Comparative Study, Thricomonas Infections, Vaginitis, Vaginosis, BacterialAbstract
Introduction: Vaginal dysfunction is one of the most prevalent pathologies in the health system and is a reason for frequent consultation. Bacterial vaginosis, candidiasis, trichomoniasis and aerobic vaginitis are distinguished as its etiology. Objective: To compare the categorization method in Basic Vaginal States with the microbiological method used in a health service in Montevideo, in the evaluation of vaginal dysfunction. Materials and methods: 132 patients were studied, between June 2016 and May 2017. The first method used the microbial morphological study and the inflammatory response to identify five Basic Vaginal States. The second method used microscopic observation in fresh and by Gram stain, culture and the signs and symptoms present for Candidiasis; the numerical value of Nugent for Bacterial Vaginosis and the observation of mobile trophozoites for Trichomoniasis. Results: A higher proportion of patients with an inflammatory response was observed with the second method (67% vs. 53%). A difference was found in the diagnosis of Candidiasis. Of 26 patients, only 17 were categorized as bacterial vaginosis in both methods. The diagnosis of Trichomoniasis (1,5%) did not differ. Conclusions: There are significant differences in the detection of inflammatory response and Candidiasis. Consideration of the presence of pseudomycelia or positive culture in the presence of clinical signs and symptoms increases the diagnosis of cases of Candidiasis. For bacterial vaginosis with concomitant inflammatory response, although categorized differently, the recommended clinical behavior is similar in both. The new method uses a standardized and simpler modality in the evaluation of the inflammatory response.
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(1) Touzon M, Losada M, Menghi E, Mengui C, Gatta C, Santa Cruz G, et al. Evaluación de la disfunción vaginal en mujeres embarazadas sintomáticas y asintomáticas mediante la utilización de los estados vaginales básicos (EVB) y su comparación con el estudio microbiológico convencional. Rev Argent Microbiol 2014; 46(3):182-187.
(2) Fundación Bioquímica Argentina. Guía práctica integral (clínica-laboratorio) de diagnóstico de vagi-nosis-vaginitis en la atención primaria de la mujer en edad fértil y menopausia. Disponible en: https://www.fba.org.ar/programas/prosar/GUIDELINES-VER-SION-AUTHORS.pdf [Consulta 09/09/2018].
(3) Di Bartolomeo S, Leonino AP, Rodríguez M, de Torres RA. Balance del Contenido Vaginal (BACOVA) en el diagnóstico diferencial de vaginosis-vaginitis. Reacción inflamatoria vaginal (RIV) en embarazadas sintomáticas. Acta Bioquím Clín Latinoam 2007; 41(2):247-258.
(4) Sobel JD, Reichman O, Misra D, Yoo W. Prognosis and treatment of Desquamative Inflammatory Vaginitis. Obstet Gynecol 2011; 117(4):850-855.
(5) Sobel JD. Desquamative inflammatory vaginitis: a new subgroup of purulent vaginitis responsive to topical 2% clindamycin therapy. Am J Obstet Gynecol 1994; 171(5):1215-1220.
(6) Braselli A, Cuevas L, Pedreira W, Abreu H, Russi C, Balleste R et al. Programa Prioritario de Infecciones de transmisión sexual y SIDA. Setiembre 2005. Ministerio de Salud Pública. Uruguay. 54 p. Disponible en: http://www.sguruguay.org/documen-tos/msp-programa-prioritario-infecciones-transmi-sion-sexual-sida.pdf [Consulta 09/09/2018].
(7) Sobel JD. Epidemiology and pathogenesis of recurrent vulvovaginal candidiasis. Am J Obstet Gynecol 1985; 152(7 pt 2):934-935.
(8) McCormack WM, Augenbraun MH. Vulvovaginitis y cervicitis. En: Mandell GL, Bennet JE, Douglas R. Enfermedades infecciosas. Principios y Práctica. 8° ed. Barcelona: Elsevier, 2016. p.1423-1426.
(9) Fundación Bioquímica Argentina. Programa de Salud Sexual y Reproductiva. Proyecto Disfunción Vaginal. Manual de Procedimientos BACOVA 2015. [CD-ROM] Buenos Aires, 2015.
(10) Wiese W, Patel SR, Patel SC, Ohl CA, Estrada CA. A meta-analysis of the Papanicolau smear and wet mount for the diagnosis of vaginal trichomoniasis. Am J Med 2000; 108(4):301-308.
(11) Patil MJ, Nagamoti JM, Metgud SC. Diagnosis of Trichomonas vaginalis from Vaginal Specimens by Wet Mount Microscopy, In Pouch TV Culture System, and PCR. J Glob Infect Dis 2012; 4(1):22-25.
(12) Roper P, Nabón A, Castro M. Manual de procedimientos de Exudados vaginales y endocervicales. H.C.FF.AA., Dpto. L.A.C., Servicio de Microbiología. POE 001/16. Versión N°3.
(13) Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of Gram stain interpretation. J Clin Microbiol 1991; 29(2):297-301.
(14) Villaseca R, Ovalle A, Amaya F, Labra B, Escalona N, Lizana P, et al. Infecciones vaginales en un Centro de Salud Familiar de la Región Metropolitana, Chile. Rev Chilena Infectol 2015; 32(1):30-36.
(15) Costamagna SR, Dupin J, Vaylet S, Pellegrino P. Evaluación del fijador-colorante azul de metileno para el diagnóstico directo de Tricomonas vaginalis. Acta Bioquím Latinoam 2004; 38(3):307-9.
(16) Anderson MR, Klink K, Cohrssen A. Evaluation of vaginal complaints. JAMA 2004; 291(11):1368-1379.
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