Desquamative inflammatory vaginitis: A newly defined entity

Gardner, Herman L.

doi:10.1016/0002-9378(68)90399-2

“…The first clinical description of desquamative inflammatory vaginitis (DIV) is attributed to Scheffey et al [4] in 1956. In 1968, Gardner [5] defined the clinical and cytological characteristics of this entity, which is distinguished by a purulent vaginal discharge, immature vaginal squamous epithelial cells, an increased number of polymorphonuclear leukocytes, and obvious vaginal inflammatory signs. Over the last 44 years, there has been little progress in defining the epidemiology and cause of this clinical syndrome, and treatment has been empirical and largely unsuccessful.…”

Section: Discussionmentioning

confidence: 99%

Aerobic vaginitis and mixed infections: comparison of clinical and laboratory findings

Fan

¹

,

Yue

²

,

Geng

³

et al. 2012

Arch Gynecol Obstet

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AV is a common vaginal infection, and it is often mixed with other infections, especially VVC, BV and TV. The symptoms and signs of AV mixed infections are atypical. If a patient has vaginal complaints, it is necessary to determine whether AV or mixed infections are present. Oral moxifloxacin is effective in treating AV, and an appropriate course should be selected taking the severity of AV into consideration.

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“…In practice, a score of 8 to 10 is usually identical to so-called 'desquamative vaginitis' (Fig. 1, Patients E and F), so that such a diagnosis can be seen as the most extreme form of aerobic vaginitis 3,15 . As the purpose of this study was to detect vaginal bacterial abnormalities, we excluded all bacterial causes of cervicitis from the analysis, but not vaginal presence of Candida or Trichomonas infection, because the possible influence these micro-organisms may have on the vaginal bacterial flora was also of interest to us.…”

Section: Grading Of the Vaginal Smearsmentioning

confidence: 99%

Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis

Donders

¹

,

Vereecken²,

Bosmans³

et al. 2002

BJOG

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Objective To define an entity of abnormal vaginal flora: aerobic vaginitis.Design Observational study.Setting University Hospital Gasthuisberg, Leuven, Belgium.Sample 631 women attending for routine prenatal care or attending vaginitis clinic.Methods Samples were taken for fresh wet mount microscopy of vaginal fluid, vaginal cultures and measurement of lactate, succinate and cytokine levels in vaginal fluid. Smears deficient in lactobacilli and positive for clue cells were considered to indicate a diagnosis of bacterial vaginosis. Aerobic vaginitis was diagnosed if smears were deficient in lactobacilli, positive for cocci or coarse bacilli, positive for parabasal epithelial cells, and/or positive for vaginal leucocytes (plus their granular aspect). Results Genital complaints include red inflammation, yellow discharge, vaginal dyspareunia. Group B streptococci, escherichia coli, staphylococcus aureus and trichomonas vaginalis are frequently cultured.Vaginal lactate concentration is severely depressed in women with aerobic vaginitis, as in bacterial vaginosis, but vaginal succinate is not produced. Also in contrast to bacterial vaginosis, aerobic vaginitis produces a host immune response that leads to high production of interleukin-6, interleukin-1-b and leukaemia inhibitory factor in the vaginal fluid. Conclusion Aerobic vaginitis is associated with aerobic micro-organisms, mainly group B streptococci and E. coli. Its characteristics are different from those of bacterial vaginosis and elicit an important host response. The most severe form of aerobic vaginitis equals desquamative inflammatory vaginitis. In theory, aerobic vaginitis may be a better candidate than bacterial vaginosis as the cause of pregnancy complications, such as ascending chorioamnionitis, preterm rupture of the membranes and preterm delivery.

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“…In practice, a score of 8 to 10 is usually identical to so-called 'desquamative vaginitis' (Fig. 1, Patients E and F), so that such a diagnosis can be seen as the most extreme form of aerobic vaginitis 3,15 .…”

Section: Grading Of the Vaginal Smearsmentioning

confidence: 99%

Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis

Donders

¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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Objective To define an entity of abnormal vaginal flora: aerobic vaginitis.Design Observational study.Setting University Hospital Gasthuisberg, Leuven, Belgium.Sample 631 women attending for routine prenatal care or attending vaginitis clinic.Methods Samples were taken for fresh wet mount microscopy of vaginal fluid, vaginal cultures and measurement of lactate, succinate and cytokine levels in vaginal fluid. Smears deficient in lactobacilli and positive for clue cells were considered to indicate a diagnosis of bacterial vaginosis. Aerobic vaginitis was diagnosed if smears were deficient in lactobacilli, positive for cocci or coarse bacilli, positive for parabasal epithelial cells, and/or positive for vaginal leucocytes (plus their granular aspect). Results Genital complaints include red inflammation, yellow discharge, vaginal dyspareunia. Group B streptococci, escherichia coli, staphylococcus aureus and trichomonas vaginalis are frequently cultured.Vaginal lactate concentration is severely depressed in women with aerobic vaginitis, as in bacterial vaginosis, but vaginal succinate is not produced. Also in contrast to bacterial vaginosis, aerobic vaginitis produces a host immune response that leads to high production of interleukin-6, interleukin-1-b and leukaemia inhibitory factor in the vaginal fluid. Conclusion Aerobic vaginitis is associated with aerobic micro-organisms, mainly group B streptococci and E. coli. Its characteristics are different from those of bacterial vaginosis and elicit an important host response. The most severe form of aerobic vaginitis equals desquamative inflammatory vaginitis. In theory, aerobic vaginitis may be a better candidate than bacterial vaginosis as the cause of pregnancy complications, such as ascending chorioamnionitis, preterm rupture of the membranes and preterm delivery.

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Desquamative inflammatory vaginitis: A newly defined entity

Cited by 57 publications

References 2 publications

Aerobic vaginitis and mixed infections: comparison of clinical and laboratory findings

Aerobic vaginitis and mixed infections: comparison of clinical and laboratory findings

Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis

Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis

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