Recurrent vaginitis is a leading reason for visiting a gynaecologist, with bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) being the most common diagnoses. Reasons and mechanisms behind their recurrent nature are poorly understood. We conducted a genome-wide association study (GWAS) to find possible genetic risk factors for recurrent vaginitis using data from a large population-based biobank, the Estonian Biobank. The study included 6870 cases (at least two episodes of vaginitis) and 5945 controls (no vaginitis episodes). GWAS approach included single marker and gene-based analyses, followed by functional annotation of associated variants and candidate gene mapping.In single marker analysis, one statistically significant (P = 7.8 × 10-9) variant rs1036732378 was identified on chromosome 10. The gene-based association analysis identified one gene, KRT6A, that exceeded the recommended significance threshold (P = 2.6 × 10-6). This is a member of the keratin protein family and is expressed during differentiation in epithelial tissues.Functional mapping and annotation of genetic associations by using adjusted significance level identified 22 potential risk loci that may be associated with recurrent vaginitis phenotype. Comparison of our results with previous studies provided nominal support for LBP (associated with immune response to vaginal bacteria) and PRKCH genes (possible role in keratinocyte differentiation and susceptibility to candidiasis).In conclusion, this study is the first highlighting a potential role of the vaginal epithelium in recurrent vaginitis.

As an emerging surgical technology, tissue removal systems have been widely used in the treatment of endometrial polyps due to its characteristics of less endometrial damage, shorter learning curve and clearer vision of the operative field. There are few cases in the literature reporting serious complications after endometrial polypectomy using tissue removal systems. As known, septic shock is a rare complication following hysteroscopic polypectomy. Now, we present the case of a 23-year-old woman who developed septic shock after polypectomy with tissue removal system. The patient had a history of recurrent vaginitis for more than half a year. Due to endometrial polyps, she was admitted to our hospital and scheduled to undergo hysteroscopic endometrial polypectomy. Three hours after the endometrial polypectomy using the tissue removal system, the patient had shock symptoms such as increased body temperature, decreased blood pressure and increased heart rate. Then, the patient was successfully treated and discharged after anti-infection and anti-shock treatments. The purpose of this case report is to remind clinicians to consider the possibility of serious infection and comprehensively evaluate the risk of infection before choosing hysteroscopic devices for endometrial polyps, especially for patients who choose the mechanical hysteroscopic tissue removal systems. Furthermore, the mechanical hysteroscopic tissue removal systems should be used with caution in patients with previous recurrent vaginitis.

Incomplete merging of the Müllerian ducts may result in vaginal septa or even completely separate vaginal canals. It may also cause cervical malformation. In most cases, there are only rudimentary vaginal septations. Only a few reports describing completely separated vaginal canals (vagina duplex) and a cervix duplex in dogs have been published. This article reports the case of a bitch presented with recurrent vaginitis and cystitis. The symptoms always appeared following the dog\'s heat. The bitch had been pre-treated by a prior veterinarian as well as in a prior clinic. When presented in the clinic, a vaginal septum was suspected based on digital vaginal examination. Ultrasonographic examination and urinalysis allowed for the diagnosis of bacterial cystitis, which was subsequently treated with antibiotics. The bitch was presented again for vaginal endoscopy, transection of the vaginal septum, and ovariohysterectomy. Both vagina duplex and cervix duplex were diagnosed. Due to the extensive dimensions of the findings, the altered tissue was not resected. No more bacteria were detected in a repeated urine analysis. After spaying, the bitch showed no recurrence of symptoms of cystitis or vaginitis.
Durch die unvollständige Verschmelzung der Müllerschen Gänge können vaginale Septen bis hin zu vollständig getrennten Vaginalkanälen entstehen. Auch zervikale Missbildungen können hierdurch auftreten. Meist handelt es sich nur um rudimentäre vaginale Septierungen. Über vollständig getrennte Vaginalkanäle (Vagina duplex) sowie über die Zervix duplex sind in der Literatur beim Hund nur vereinzelte Berichte zu finden. In diesem Artikel wird vom Fall einer Hündin berichtet, welche aufgrund von rezidivierender Vaginitis und Zystitis vorgestellt wurde. Die Symptome traten jedes Mal nach der Läufigkeit auf. Die Hündin war bereits von der Haustierärztin und einer anderen Klinik vorbehandelt worden. Bei der Vorstellung in der Klinik wurde in der digitalen vaginalen Untersuchung der Verdacht eines vaginalen Septums gestellt. In der sonografischen Untersuchung und der Harnuntersuchung wurde eine Zystitis diagnostiziert, welche antibiotisch nach Resistenztest behandelt wurde. Die Hündin wurde erneut vorstellig zur Endoskopie der Vagina in Narkose, der Durchtrennung des vaginalen Septums und zur Ovariohysterektomie. Hierbei wurden eine Vagina duplex und eine Zervix duplex diagnostiziert. Auf die geplante Resektion des Septums wurde aufgrund des großen Ausmaßes der Missbildung in Absprache mit den Besitzern verzichtet. In der Urinuntersuchung waren keine Keime mehr nachweisbar. Nach der Kastration zeigte die Hündin keine erneuten Symptome einer Zystitis oder Vaginitis.

Plasma cell, or Zoon\'s, vulvitis (PCV) is a rare inflammatory disorder of the female genital tract. Clinically, it is characterized by erythematous mucosal lesions associated with burning, pruritus, and dyspareunia. Histologically, it is characterized by the thinning of the epithelium with the infiltration of plasma cells in the underlying dermis. There are few case reports describing predominantly vaginal symptoms. Our patient is a 53-year-old postmenopausal female presenting for the gynecologic evaluation of a vaginal pinching sensation and vulvar irritation for three months. On examination, vaginal mucosa was notable for erythematous macules and papules with focal tenderness. Initial evaluation was significant for bacterial vaginosis. This was treated, but it did not improve the patient\'s presenting symptoms. Our preliminary working diagnosis was vulvovaginal atrophy. Biopsies showed plasmacytosis mucosae consistent with Zoon\'s vaginitis. The patient was treated with external clobetasol ointment and hydrocortisone 25 mg vaginal suppositories with improvement in symptoms. Female genital tract lesions engender a range of differential diagnoses, including infectious, immunologic, and malignant causes. In this patient, our initial working diagnosis of genitourinary syndrome of menopause suggested that local hormonal treatment was indicated. However, histological diagnosis directed the use of steroid treatment, ultimately improving the patient\'s symptoms.

UNASSIGNED: We aimed to investigate the pathogen infection in vaginal secretions of women in Linyi area.
UNASSIGNED: From October 2016 to September 2018, a total of 49,343 vaginal secretion specimens from women who attended Women and Children\'s Health Care Hospital of Linyi District, Shandong Province, China were used to detect the cleanliness, Candida, clue cells, Trichomonas, etc. with Ultra-high power microscopy.
UNASSIGNED: Among the 49343 patients, 6377 had vaginal cleanliness of degree I∼II, the detection rate was 37.89%; 10455 cases of III∼IV degree, the detection rate was 62.11%; 13193 cases of simple vaginal pathogen infection, the detection rate was 26.74%. Among them, 9256 cases of vaginal Candida (VVC) had a detection rate of 18.76%; 3176 cases of Bacterial vaginosis (BV) had a detection rate of 6.44%; and 761 cases of Trichomonas infection (TV) had a detection rate 1.54%; 899 cases of mixed infection. The detection rate was 1.82% and the detection rate of each pathogen in the 18-30 year old group was the highest. The detection rates of VVC, BV, TV and MVI were 10.80%, 3.25%, 0.65%, 1.00%, repsectively.
UNASSIGNED: The incidence of VVC women with vaginitis in Linyi was the highest, and the incidence was mainly between 18 and 40 years old. The infection rate of VVC, BV and MVI pathogens was the highest in summer, and the infection rate of TV was the highest in autumn.

Shigella vulvovaginitis is an uncommon aetiology of prepubertal vaginal bleeding that should be considered in the differential diagnosis, especially in patients who have travelled to developing countries. A young girl presented with prepubertal vaginal bleeding, pelvic pain, occasional dysuria and no gastrointestinal symptoms. After a year-long extensive workup, including vaginoscopy and biopsy, genital culture and Gram stain revealed vulvovaginitis due to Shigella flexneri After review of bacterial sensitivity, the patient was given a 30-day course of sulfamethoxazole-trimethoprim. The patient returned to the clinic 1 month later with no signs of vaginal bleeding, discharge or pelvic pain. This case prompted review of the indicated evaluation and differential diagnosis of prepubertal vaginal bleeding, including infectious aetiologies such as Shigella vulvovaginitis with the authors\' goal to expedite diagnosis and treatment in paediatric patients.

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A 31-year-old woman, gravida 3 para 1, at 10 weeks of gestation presented to a vulvar specialty clinic with a 6-month history of vulvar pruritus that had not responded to the treatment prescribed by her referring gynecologist. Examination was consistent with vaginitis and vulvar lichen simplex chronicus. Fungal cultures ultimately revealed Candida albicans and Cokeromyces recurvatus. The organisms were eradicated with oral fluconazole and intravaginal terazole. Few cases of isolation of C. recurvatus in humans have been reported. Both immunosupressed and immuno-competent hosts have been identified, with the most common sites of isolation being the genitourinary and gastrointestinal tracts. Asymptomatic colonization and superficial disease have been noted; no invasive cases of C. recurvatus have been described. Even fewer cases of C. recurvatus infection during pregnancy have been reported, and symptomatic vulvovaginal disease has been described only once prior to this case report.

OBJECTIVE: Aerobic vaginitis (AV) has drawn increasing attention because of its threat to women\'s reproductive health and pregnancy. However, little is known about the overall structure of vaginal bacterial communities in women with AV.
METHODS: The diversity of vaginal microbiota was evaluated by amplicon sequencing targeting the 16S rRNA V4 region. Routine laboratory tests, including cultivation, were used.
RESULTS: Firmicutes (mainly Lactobacillus crispatus and L. iners) were dominant in healthy women (n = 160), while Actinobacteria and Bacteroidetes were strongly associated with AV (n = 80). The onset of AV was marked by a striking decline in L. crispatus and an increase in multiple aerobes, including Streptococcus agalactiae, S. anginosus, etc. The overall drug resistance level of gram-positive bacteria against erythromycin and clindamycin was high, and the overall drug resistance level of gram-negative bacteria against ampicillin was high.
CONCLUSIONS: Multiple aerobes and facultative anaerobes were involved in vaginal dysbiosis, which was associated with decreasing L. crispatus levels. Probiotics containing L. crispatus may be potential supplementary agents.

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