In cooperation with

Abstract

Gynecological infections

The article reviews the actual development of genital infections in woman. Since the human vagina makes contact with the bacteria-laden environment, while maintaining strict asepsis in their proximal organs, the age depending conditions of vaginal colonisation with lactobacillus ssp. and the partnership between the vaginal tissues are described. Even if many types of bacteria normally live in balance in the vagina, the overgrowth of certain bacteria may prevail and lead to bacterial vaginosis providing preconditions for further infectious sequels. Persistent lower genital tract infections have an association with subclinical and acute pelvic inflammatory disease as well as lower urinary tract infection. Furthermore they increase the incidence and prevalence of other infectious diseases like HPV and HIV not only by sharing common risks of sexual behaviour but moreover by provoking a non-specific inflammatory state and vulnerability of the vaginal tissue as a predisposition for the transmission and persistence of other pathogenic organisms. The risk factors for the development of lower genital tract infections are discussed in detail. Using a syndromic approach, the features of genital complaints caused by infections are depicted and specific diagnosis and treatment are recommended. Although a major limitation of the syndromic case management approach for women is that it is a poor predictor for subclinical or cervical infection.

CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2010; 6(3):234-258

Keywords
Lower genital tract infection, sexually transmitted diseases, pelvic inflammatory disease,genital syndromes,subclinical genital infections

Axel Schäfer
Klinik für Gynäkologie, Charité Campus Virchow-Klinikum, Berlin

Reviewer: Oumar Camara , Jena

Schäfer A. Infektionen... Gynakol Geburtsmed Gynakol Endokrinol 2010;6(3):234-258 publiziert 30.11.10 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2010 ISSN 1614-8533
Zaher Halwani, Berlin