Atlas Of Clinical Fungi Second Edition

Vaginal discharge Wikipedia. Vaginal discharge is a mixture of liquid, cells, and bacteria that lubricates and protects the vagina. This mixture is constantly produced by the cells of the vagina and cervix and it exits the body through the vaginal opening. The composition, amount, and quality of discharge varies between individuals as well as through the various stages of sexual and reproductive development. Normal vaginal discharge may have a thinner, watery consistency or a thick, sticky consistency, and may be clear or white in color. Normal vaginal discharge may be large in volume but typically does not have a strong odor, nor is it typically associated with itching or pain. While most discharge represents normal functioning of the body, some changes in discharge can reflect infection or other pathological processes. Infections that may cause changes in vaginal discharge include vaginal yeast infections, bacterial vaginosis, and sexually transmitted infections. The characteristics of abnormal vaginal discharge vary depending on the cause, but common features include a change in color, a foul odor, and associated symptoms such as itching, burning, pelvic pain, or pain during sexual intercourse. Normal dischargeedit. Normal vagina and cervix during a medical speculum exam demonstrating IUD strings at the opening of the cervix and normal milky white vaginal discharge on the vaginal walls, cervix, and pooled in vaginal fornix. Original Article. Intraperitoneal Cisplatin and Paclitaxel in Ovarian Cancer. Deborah K. Armstrong, M. D., Brian Bundy, Ph. D., Lari Wenzel, Ph. D., Helen Q. Huang, M. S. Normal vaginal discharge is composed of cervical mucus, vaginal fluid, shedding vaginal and cervical cells, and bacteria. The majority of the liquid in vaginal discharge is mucus produced by glands of the cervix. The rest is made up of transudate from the vaginal walls and secretions from glands Skenes and Bartholins. The solid components are exfoliated epithelial cells from the vaginal wall and cervix as well as some of the bacteria that inhabit the vagina. These bacteria that live in the vagina do not typically cause disease. In fact, they can protect the individual from other infectious and invasive bacteria by producing substances such as lactic acid and hydrogen peroxide that inhibit growth of other bacteria. The normal composition of bacteria in the vagina vaginal flora can vary, but is most commonly dominated by lactobacilli. On average, there are approximately 1. Normal vaginal discharge is clear, white, or off white. The consistency can range from milky to clumpy, and odor typically mild to non existent. The majority of the discharge pools in the deepest portion of the vagina the posterior fornix2 and exits the body over the course of a day with the force of gravity. A typical reproductive age woman produces 1. During sexual arousal and intercourse, the amount of fluid in the vagina increases due to engorgement of blood vessels surrounding the vagina. This engorgement of blood vessels increases the volume of transudate from the vaginal walls. Transudate has a neutral p. H, so increases in its production can temporarily shift vaginal p. H to be more neutral. Semen has a basic p. The 2 broad clinical categories of UTI are pyelonephritis upper UTI and cystitis lower UTI. The most common causative organisms are bowel flora. Scientific Conference Calendar of Conferences and Meetings on Molecular Biology. H and can neutralize the acidity of the vagina for up to 8 hrs. The composition and amount of vaginal discharge changes as an individual goes through the various stages of sexual and reproductive development. NeonataleditIn neonates, vaginal discharge sometimes occurs in the first few days after birth. This is due to exposure to estrogen while in utero. Neonatal vaginal discharge may be white or clear with a mucous texture, or it may be bloody from normal transient shedding of the endometrium. PediatriceditThe vagina of girls before puberty is thinner and has a different bacterial flora. Vaginal discharge in pre pubertal girls is minimal with a neutral to alkaline p. H ranging from 6 to 8. The composition of the bacterial population in pre pubertal girls is dominated by staphylococcus species, in addition to a range of anaerobes, enterococci, E. PubertyeditDuring puberty, the hormone estrogen begins to be produced by the ovaries. Even before the beginning of menses up to 1. Estrogen matures vaginal tissues and causes increased production of glycogen by epithelial cells of the vagina. These higher levels of glycogen in the vaginal canal support the growth of lactobacilli over other bacterial species. When lactobacilli use glycogen as a food source, they convert it to lactic acid. Therefore, the predominance of lactobacilli in the vaginal canal creates a more acidic environment. In fact, the p. H of the vagina and vaginal discharge after puberty ranges between 3. Menstrual cycleeditThe amount and consistency of vaginal discharge changes as the menstrual cycle progresses. In the days right after menstruation, vaginal discharge is minimal and its consistency is thick and sticky. When approaching ovulation, the rising estrogen levels cause a concomitant increase in vaginal discharge. The increase in the amount of discharge at ovulation is 3. The discharge also changes in color and consistency during this time, becoming clear with an elastic consistency. After ovulation the bodys progesterone levels increase, which causes a decrease in the amount of vaginal discharge. The consistency of the discharge once again becomes thick and sticky and opaque in color. The discharge continues to decrease from the end of ovulation until the end of menstruation, and then after menstruation it begins its rise again. PregnancyeditDuring pregnancy, vaginal discharge volume increases as a result of the bodys increased levels of estrogen and progesterone. The discharge is usually white or slightly gray, and may have a musty smell. The normal discharge of pregnancy does not contain blood or cause itching. The p. H of the vaginal discharge in pregnancy tends to be more acidic than normal due to increased production of lactic acid. This acidic environment helps to provide protection from many infections, though conversely it also makes women more susceptible to vaginal yeast infections. MenopauseeditWith the drop in estrogen levels that comes with menopause, the vagina returns to a state similar to pre puberty. Specifically, the vaginal tissues thin, become less elastic blood flow to the vagina decreases the surface epithelial cells contain less glycogen. With decreased levels of glycogen, the vaginal flora shifts to contain fewer lactobacilli, and the p. H subsequently decreases to a range of 6. The overall amount of vaginal discharge decreases in menopause. While this is normal, it can lead to symptoms of dryness and pain during penetrative sexual intercourse. These symptoms can often be treated with vaginal moisturizerslubricants or vaginal hormone creams. Abnormal dischargeeditAbnormal discharge can occur in a number of conditions, including infections and imbalances in vaginal flora or p. H. Abnormal vaginal discharge may also not have a known cause. In one study looking at women presenting to clinic with concerns about vaginal discharge or a foul smell in their vagina, it was found that 3. Chlamydia, Gonorrhea, Trichomonas, or Genital Herpes. Diagnosing the cause of abnormal vaginal discharge can be difficult, though a potassium hydroxide test or vaginal p. I/51ghFwpYTHL._SR600%2C315_PIWhiteStrip%2CBottomLeft%2C0%2C35_PIAmznPrime%2CBottomLeft%2C0%2C-5_SCLZZZZZZZ_.jpg' alt='Atlas Of Clinical Fungi Second Edition' title='Atlas Of Clinical Fungi Second Edition' />Enhanced PDF Standard PDF 820. KB Morita Prize Case Report Posters PZ01 PZ01. Supernumerary mesiodentes how to manage Despite advances in diagnostic techniques and treatment, brain abscess remains a challenging clinical problem with substantial case fatality rates. Delays in. H analysis may be used. NOTE This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used. To access online sources, copy and paste the URL into your browser. Sources Used in Current Review. Gram stain. Mayo Medical Laboratories. Available online at http www. ClinicalandInterpretive8. Accessed January 2. Gram stain. University of Rochester Medical Center, Health Encyclopedia. Available online at https www. Content. Type. ID1. Content. IDgramstain. Accessed January 2. Patolia S., et al. Updated 2. 01. 5 December 1. Gram Stain. Medscape. Available online at http emedicine. Accessed January 2. Hazen, K. C. Modified 2. October. Microscopy. Merck Manual, Professional Version. Available online at http www. Accessed January 2. Sources Used in Previous Reviews. Physicians Office Laboratory Microscopy Atlas, 3rd ed, 2. Henderson Murray. American Academy for Family Physicians Proficiency Testing. Pagana, K. D. Pagana, T. J. 2. 00. 7. Mosbys Diagnostic and Laboratory Test Reference 8th Edition Mosby, Inc., Saint Louis, MO. Pp 6. 94, 7. 07, 7. Wu, A. 2. 00. 6. Tietz Clinical Guide to Laboratory Tests, 4th Edition Saunders Elsevier, St. Louis, MO. Pp 1. 56. Forbes, B. et. al. Bailey Scotts Diagnostic Microbiology, 1. Edition Mosby Elsevier Press, St. Louis, MO. Pp 8. 0 8. Vorvick, L. Updated 2. August 9. Endocervical gram stain. Medline. Plus Medical Encyclopedia On line information. Available online at http www. Accessed February 2. Yuki Uehara, Y. et. September 1. 8. Impact of Reporting Gram Stain Results from Blood Culture Bottles on the Selection of Antimicrobial Agents. Medscape Today from American Journal of Clinical Pathology On line information. Available online at http www. Accessed February 2. Henrys Clinical Diagnosis and Management by Laboratory Methods. Mc. Pherson R, Pincus M, eds. Philadelphia, PA Saunders Elsevier 2. Pp 1. 01. 6 1. 01. Cavanaugh D, Keen M, American Society for Microbiology. The Gram Stain An Animated Approach. Available online at http www. Accessed September 2. Descargar Gratis Libro Que Esperar Cuando Se Esta Esperando Pdf. Updated July 2. 2, 2. Smith A, Hussey M, American Society for Microbiology. Gram Stain Protocols. Available online at http www. Accessed September 2. Updated February 2. Patolia S, et al. Gram Stain. Medscape Reference article. Available online at http emedicine. Accessed September 2. Uehara Y, et al. Impact of Reporting Gram Stain Results from Blood Culture Bottles on the Selection of Antimicrobial Agents. Am J Clin Pathol 2. Available online at http ajcp. Accessed September 2. Munson E, et al. Mechanisms To Assess Gram Stain Interpretation Proficiency of Technologists at Satellite Laboratories. J. Clin. Microbiol. November 2. 00. 7 vol. Available online at http jcm. Accessed September 2. Forbes, B. et. al. Bailey Scotts Diagnostic Microbiology, 1. Edition Mosby Elsevier Press, St. Louis, MO. Pp 8. 0 8.