Broad spectrum antibiotics can induce fungal vaginitis.
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Which groups of people are prone to fungal vaginitis?
According to statistics, about 10% ~ 20% of healthy women have candida albicans in their vaginas. So under what circumstances will these candida albicans multiply into pathogenic bacteria?
(1) Extensive use of broad-spectrum antibiotics: Usually, there are many bacteria in the vagina of women, and these different flora restrict each other to form a state of * * *, which is not pathogenic. The extensive and long-term application of broad-spectrum antibiotics makes the flora in vagina disorder, and the mutual inhibition changes, and Candida albicans can multiply in large numbers. With the increasing use of antibiotics, the incidence of fungal vaginitis has also increased.
(2) Pregnancy: The level of sex hormones during pregnancy is significantly higher than usual, which will increase the content of glycogen in vaginal epithelial cells and increase the acidity of vagina, thus forming an environment conducive to the growth of Candida; At the same time, pregnancy will reduce the immunity of cells and make candida easy to cause disease. According to statistics,13 of pregnant women have candida in vagina, and the incidence rate is about 15%.
(3) Diabetes: After suffering from diabetes, the body's glucose metabolism is disordered, blood sugar is increased, the content of glycogen in vaginal epithelial cells is increased, and the acidity in vagina is also increased. Candida is suitable for growth and reproduction.
(4) Application of corticosteroids: Long-term application of corticosteroids will reduce the phagocytosis of white blood cells and reduce the immunity of the body; At the same time, corticosteroids can also increase the body's blood sugar level and increase the possibility of fungal vaginitis.
(5) Application of immunosuppressants: It will reduce the body's immunity and is prone to fungal vaginitis.
(6) Application of estrogen: Estrogen can deposit glycogen in vaginal epithelial cells. These glycogen are decomposed into lactic acid under the action of Lactobacillus vaginalis, which increases the acidity of vagina and is beneficial to the growth of Candida.
(7) Fungal vaginitis is also prone to occur when severe diseases lead to decreased resistance, or when vitamin B complex is lacking.
In addition, some people think that oral contraceptives will increase the incidence of fungal vaginitis.
Can fungal vaginitis be contagious?
Although 10% ~ 20% of healthy women carry candida in vagina, and some special situations in life, such as long-term use of antibiotics and diabetes, can induce vaginal candidiasis infection, but many times fungal vaginitis can also be infected from the outside. When women have sexual contact with men with positive candida culture, the infection rate is 80%; About12 of men will be infected if they have sexual contact with women with fungal vaginitis. In other words, fungal vaginitis can be transmitted through sexual behavior, which is why when a woman suffers from fungal vaginitis, her spouse should also receive treatment at the same time. In addition, indirect contact infection is also a route of transmission of fungal vaginitis. Contact with mold, hit the cheek, set up a tomb? * * * Toilets, bathtubs, bath chairs, towels, and dirty toilet paper can spread. Fungal vulvovaginitis can occur when the number of candida in infected vulva and vagina reaches a certain level.
What are the clinical manifestations of fungal vaginitis and how to diagnose it?
The most common symptom of fungal vaginitis is pruritus vulvae, and leucorrhea is obviously increased. The patient's itching symptoms are sometimes mild and sometimes severe, and sometimes stop. Vaginitis caused by fungal vaginitis is generally more obvious than trichomonal vaginitis, and those with severe itching are restless and insomnia. Patients will also have vaginal burning sensation, especially when urinating. When the inflammation is serious, there will be frequent urination, dysuria and sexual pain. Leucorrhea is another major symptom of this disease. Leucorrhea is generally sticky in texture, white or yellow in color, or thin. The leucorrhea of typical fungal vaginitis is bean curd residue-like or milky white block. See you during gynecological examination: according to the severity of the disease, the labia minora and vaginal mucosa have different degrees of congestion and labia minora edema. There are many sticky leucorrhea in vagina or vaginal mucosa covered with white membrane. Wipe off the white membrane, the exposed mucosa is red, swollen, erosive or superficial ulcer can be seen.
If the symptoms are typical, it is not difficult to make a diagnosis, but it must be combined with routine laboratory tests to make a diagnosis. The commonly used method is hanging drop method: drop a drop of physiological saline or 10% potassium hydroxide solution on the glass slide, and take a small amount of secretion and put it under a microscope for direct examination. If pseudohyphae and spores are found, it means that Candida is in a pathogenic state at this time and can be diagnosed as fungal vaginitis. If the patient's symptoms are suspicious, but no false hyphae are found by direct microscopic examination for many times, bacterial culture should be done.
How to treat fungal vaginitis?
Mycotic vaginitis can be treated by simple western medicine or by combination of traditional Chinese and western medicine.
(1) General treatment: actively treat other diseases that can cause fungal vaginitis and exclude susceptible factors. Keep vulva clean and dry, and avoid scratching. Sexual life is forbidden during treatment. Not suitable for spicy food.
(2) Changing the pH value of vagina: The most suitable pH value for candida growth is 5.5, so washing vulva and vagina with alkaline solution and changing the pH value of vagina will inhibit the growth and reproduction of mold. Vagina can be washed with 2% ~ 4% baking soda water, 1 ~ 2 times a day, and 2 weeks is 1 course of treatment. After washing, dry the vulva and keep it dry to inhibit the growth of candida.
(3) Vaginal medication: Vaginal medication of imidazole suppository has a good effect on fungal vaginitis. Clotrimazole suppository every night 1 capsule, washed and put into vagina. The course of treatment is 1 from 10 to 14 days. Or take dakening suppository 1 capsule every night, and apply the medicine to the vagina after cleaning, with a course of treatment of 1 for 7 days.
(4) Ointment for external use: Clotrimazole ointment or dyclonine ointment can be used externally to treat vulvitis caused by mold infection and relieve pruritus and pain of vulva. For external use several times a day for 2 weeks. Yifuqing ointment is made of econazole as the main medicine and a small amount of topical steroid therapy, which has good antipruritic effect and is more suitable for patients with mycotic vulvitis and vaginitis. External use of vulva, morning and evening 1 time.
(5) Oral medication: Because fungal infection can spread between husband and wife through sexual life, both parties can take oral medication and inhibit intestinal candidiasis. Oral fluconazole: 150 mg once, once. Or take spironolactone orally: if it is the first time to be infected with candidal vaginitis, take 200mg each time, after breakfast and dinner, only 1 day; For recurrent fungal vaginitis, the dose of Spirillum should be increased, which can be 200 mg each time, 1 time/day for 3 days, or twice a day, 100 mg each time for 3 days. Take medicine after meals.
(6) Chinese herbal medicine treatment: decocting and fumigating vulva with traditional Chinese medicine with the functions of clearing away heat and toxic materials, killing insects and relieving itching can not only relieve symptoms, but also inhibit the eradication of candida. Because the symptoms of pruritus and burning pain in vulva are obviously relieved after fumigation and washing, it is more suitable for women with acute mycotic vaginitis and can alleviate the pain of patients. In addition, Chinese herbal medicines can be made into powder or suppository, and can also be used in vagina.
Prescription 1: 30g of Cortex Dictamni, 30g of Cortex Phellodendri, 30g of Radix Sophorae Flavescentis, 30g of Fructus Cnidii and 3g of Borneolum Syntheticum. Wrap the medicinal white cloth, decoct 2000 ml of juice, smoke the vulva with hot water, and sit in the bath for 20 minutes after the liquid medicine cools, once a day 1 ~ 2 times. Take out the medicine bag and dry it before fumigation, which can be reused 1 time. 7 days is 1 course of treatment. After soaking and cleaning, put 1 clotrimazole suppository or dyclonine suppository into vagina, and apply the above ointment to vulva.
Prescription ② (practical dermatosis prescription): clove 12g Pogostemon 30g Coptidis Rhizoma 15g rhubarb 30g gentian 20g alum 15g mint 15g borneol1g.
This prescription has the functions of clearing away heat, eliminating dampness, killing insects and relieving itching, and has a strong inhibitory effect on Candida albicans, other superficial skin fungi and gonococcus. Usage: daily 1 dose, decoct in water and soak vulva 1 ~ 2 times, 30 minutes each time. It can also be made into lotion and cream for external use. Married women can wash their vagina with liquid medicine 1 time every day. Continuous medication 12 days is 1 course of treatment.
Prescription ③ (latest treatment of sexually transmitted diseases): Radix Sophorae Flavescentis 30g, Fructus Cnidii 30g, Radix Gentianae 20g, Stemonae 15g, Cortex Pseudolaricis 15g, Cortex Phellodendri 15g, and Fructus Kochiae 15g.
Add 2000 ~ 3000 ml of water, fry for 30 ~ 40 minutes, remove residue, smoke and wash, and take a bath. 1 time one night, 20 ~ 30 minutes each time.
Prescription ④ (practical dermatology and venereal diseases): Sophora flavescens 30g, Fructus Cnidii 30g, Rhizoma Coptidis 30g, Cortex Phellodendri 30g? Sichuan pepper 10g dried alum 10g borneol 3g?
* * * is a fine powder, which is sterilized for later use. When in use, the vulva and vagina are washed with 3% soda water, and then an appropriate amount of medicinal powder is sprinkled on the vagina and vulva, once a day 1 ~ 2 times. Five times is 1 course of treatment.
After the above treatment, the clinical symptoms of patients will be improved quickly, but it is not certain that fungal vaginitis has been cured. Patients should insist on completing the course of treatment, and then go to the hospital to review symptoms, do gynecological examination and test vaginal secretions. If there is no abnormality, it means that it has been cured recently. After my menstruation is clean every month, I will go to the hospital to review the above examination contents 1 time for three consecutive months. If they are all negative, they are completely cured.