Obstetrics and gynecology. Inflammatory diseases of the female genital organs (viral infections, candidal colpitis) (the most important)

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Obstetrics and gynecology. Inflammatory diseases of the female genital organs (viral infections, candidal colpitis) (the most important)

Lecture notes, cheat sheets

Directory / Lecture notes, cheat sheets

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44. Inflammatory diseases of the female genital organs (viral infections, candidal colpitis)

Viral infections. The herpes virus of the second serotype and the human papillomavirus cause inflammation of the cervix. Cytomegalovirus infection proceeds in the form of carriage, but has a damaging effect on the fetus, causing, in addition to miscarriages, fetal deformities. All viral infections are latent, difficult to treat, prone to relapses and exacerbations. In case of herpes infection during pregnancy, in order to prevent infection of the fetus, delivery is performed by abdominal caesarean section. Diagnose these infections using immunofluorescence microscopy or special sera.

Treatment herpetic infection is carried out with antiviral drugs. The damaging effect of acyclovir (zovirax, virolex) affects the synthesis of viral DNA. The drugs are administered not only locally, but also orally or even intravenously. Locally applied viferon in the form of suppositories, it increases nonspecific antiviral activity. For the treatment of recurrent, difficult to treat genital herpes, famvir (Famciclovir) is used - 250-500 mg 3 times a day.

Candida colpitis. Caused by fungi of the genus Candida. Fungi of the genus Candida are present in the normal microflora of the vagina. When fungi of the genus Candida multiply, mycelium is found in the smear. Candida colpitis is characterized by the presence of white cheesy discharge. Candidiasis colpitis is not sexually transmitted. Most often, the cause of the development of candidal colpitis is uncontrolled antibacterial therapy, replacement therapy, the presence of hypovitaminosis, and hypoestrogenism. Pregnancy may be a provoking factor, as it creates hypoestrogenism. With the development of candidal colpitis, only local treatment is carried out.

Treatment. 1-2 douches with acidic solutions are necessary to normalize the vaginal pH. Clotrimazole is used in the form of cream or vaginal tablets. Representatives of econazole (ginotravalen, ginopivoril) are used in the form of vaginal tablets and suppositories. You can use pimafucin in the form of suppositories, which contain the antimycotic antibiotic katamycin. The course of treatment is 10-14 days. Terzhikan and Polygynax are prescribed in suppositories. They contain neomycin, a topical antibiotic.

Human papillomavirus infection. This infection is transmitted only through sexual contact. The virus causes ectocervix, which is small flat condylomas - papillomas, which are sometimes not visible during colposcopic examination. Cytoscopy reveals poilocytes with air bubbles in the cytoplasm (Ballon cells). This disease is difficult to diagnose and very difficult to treat, since the papilloma virus is not sensitive to the antiviral drugs acyclovir, famvir. The disease is treated with laser and cryodestruction.

Author: Ivanov A.I.

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