Vaginitis vs Vaginosis

[Zzmed]

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What's the difference between these two (if any)?

Goljan states that bacterial vaginosis caused by Gardnerella vaginalis is the most common vaginitis!

I remember that this topic has been raised before.. but i can't find it.

 

[projectlogic]

Think of vaginitis as an umbrella term. It literally means inflammation or irritation of the vagina.

It can be caused by different things, for example: bacterial infection (as seen with Gardnerella vaginalis), yeast infection (Candida), or parasite infection (Trichomonas vaginalis).

Bacterial vaginosis is just one of several things that can lead to vaginitis.

 

[chaotic mind]

What's the difference between these two (if any)?

Goljan states that bacterial vaginosis caused by Gardnerella vaginalis is the most common vaginitis!

I remember that this topic has been raised before.. but i can't find it.

Bacterial vaginosis does not cause an inflammatory response in the vagina.Its not an "-ITIS" .It is characterised by an ABSENSE of redness and vaginal/vulvar irrtiation.It is associated with an altered microbial flora of the vagina- Increased gardnerella,mycoplasma hominis,Anaerobes: Prevotella, Mobiluncus,
Bacteroides and decreased lacobacillus.No treatment is required if non-pregnant and asymptomatic,unless the patient scheduled for pelvic surgery or procedure.
Its not an STD but is seen in sexually active women.

 

[Zzmed]

Its not an STD but is seen in sexually active women.

Actually, it is not exclusively an STD.

 

[chaotic mind]

Actually, it is not exclusively an STD.

thats what i said-its not sexually transmitted but it is seen in women who are sexually active.

 

[Myxedema]

From Harrison's Principles of Internal Medicine, 18E, Chapter 130. Sexually Transmitted Infections: Overview and Clinical Approach:

Bacterial vaginosis (formerly termed nonspecific vaginitis, Haemophilusvaginitis, anaerobic vaginitis, or Gardnerella-associated vaginal discharge) is a syndrome of uncertain etiology that is characterized by symptoms of vaginal malodor and a slightly to moderately increased white discharge, which appears homogeneous, is low in viscosity, and evenly coats the vaginal mucosa.

Bacterial vaginosis is a type of non-specific vaginitis, which is associated with the overgrowth of Gardnerella, Bacteriodes (and other anaerobes), Peptostreptococcus, and Mycoplasma spp.

In summary, there are three types of vaginal infections (vaginitis):

• Vulvovaginal candidiasis: Caused by Candida albicans
• Trichomonal vaginitis: Caused by Trichomonas vaginalis
• Vulvovaginal candidiasis: Associated with Gardnerella and other bacteria listed above

 

[Zzmed]

thats what i said-its not sexually transmitted but it is seen in women who are sexually active.

The fact that it's seen in women who are sexually active doesn't mean that it's an STD though.
The pathogenesis lies in the fact that you get bacterial vaginosis when there is an imbalance in between vaginal normal flora. And that is precipitated by frequent sexual intercourse.

 

[chaotic mind]

From Harrison's Principles of Internal Medicine, 18E, Chapter 130. Sexually Transmitted Infections: Overview and Clinical Approach:

Bacterial vaginosis is a type of non-specific vaginitis, which is associated with the overgrowth of Gardnerella, Bacteriodes (and other anaerobes), Peptostreptococcus, and Mycoplasma spp.

In summary, there are three types of vaginal infections (vaginitis):

• Vulvovaginal candidiasis: Caused by Candida albicans
• Trichomonal vaginitis: Caused by Trichomonas vaginalis
• Vulvovaginal candidiasis: Associated with Gardnerella and other bacteria listed above

Harrison's also has a table which says that there is no inflammation of the vulva/vagina associated with BV.
my point is:
1.its vaginOSIS because there is no inflammatory response.
2.it is not an STD-I'm sorry if i made it sound like that
3.It is regarded as the most common vaginal infection.

 

[Myxedema]

Harrison's also has a table which says that there is no inflammation of the vulva/vagina associated with BV.
my point is:
1.its vaginOSIS because there is no inflammatory response.
2.it is not an STD-I'm sorry if i made it sound like that
3.It is regarded as the most common vaginal infection.

Not to be nitpicky, but:

1. Inflammation is present in BV, just not as severe as the other two. It is important to separate the gross appearance of inflammation (which is not present in BV) and presence of inflammation as a mechanism for pathogenesis (which is present):

Many women who present to their physicians with vaginal symptoms have a specific condition, first described by Gardner and Dukes in 1955,[92] that is now referred to as bacterial vaginosis (BV).[93,94] Inflammation and perivaginal irritation are considerably milder than in trichomoniasis or candidiasis...

(Mandell Principles and Practice of Infectious Diseases, 7E)

Bacterial vaginosis: This is the most common cause of acute vaginitis...

(Nucci, Gynecologic Pathology, 1E, p. 78)

...The three main categories of vaginitis are related to Trichomonas vaginalis infection, Candida vaginatis, and bacterial vaginosis.
Bacterial vaginosis is the most common form of vaginitis, accounting for nearly 50% of all cases. The term 'vaginosis' was introduced to indicate that, unlike the specific vaginitides, there is an increased discharge without significant inflammation...

(Robboy's Pathology of the Female Reproductive Tract, 2E, p. 115)

2. It is debated whether BV can be considered as an STD or not. For instance, both in Harrison's and Cecil, BV is discussed under the STD chapter.

3. Technically, BV is not an infection, but an overgrowth of certain elements of bacterial flora:

Bacterial vaginosis is not an infection but rather a shift in the normal bacterial vaginal flora. There is a decrease of lactobacilli and an overgrowth of Gardnerella vaginalis, Mycoplasma hominus, and anaerobes. Factors that are associated with bacterial vaginosis include multiple sex partners, a new sex partner, and douching.

(Conn's Current Therapy 2013)

 

[Stellar Clouds]

Harrison's also has a table which says that there is no inflammation of the vulva/vagina associated with BV.
my point is:
1.its vaginOSIS because there is no inflammatory response.
2.it is not an STD-I'm sorry if i made it sound like that
3.It is regarded as the most common vaginal infection.

Not to be nitpicky, but:

1. Inflammation is present in BV, just not as severe as the other two. It is important to separate the gross appearance of inflammation (which is not present in BV) and presence of inflammation as a mechanism for pathogenesis (which is present): (Mandell Principles and Practice of Infectious Diseases, 7E) (Nucci, Gynecologic Pathology, 1E, p. 78) (Robboy's Pathology of the Female Reproductive Tract, 2E, p. 115)

2. It is debated whether BV can be considered as an STD or not. For instance, both in Harrison's and Cecil, BV is discussed under the STD chapter.

3. Technically, BV is not an infection, but an overgrowth of certain elements of bacterial flora: (Conn's Current Therapy 2013)

Great. Now you have learned something new: the difference between textbook and clinical medicine.