Vulvovaginal Infections presents new knowledge to help clinicians accurately diagnose and treat their patients and highlights for researchers remaining unsolved problems and the most promising areas for continued investigation. Clinical gynecologists will find practical advice and extensive insight into solving real-life clinical scenarios.
The book opens by presenting information on the microbiology of the vagina and vaginal immunology. It then discusses the diagnosis of vulvovaginal disease, including physical examination, screening processes, and laboratory testing.
Diagnosis is followed by covering various vulvovaginal infections including bacterial vaginosis, Candida vulvovaginitis, Trichomonas vaginalis vaginitis, genital herpes, human papillomavirus genital infections, allergic vulvovaginitis, menopausal vulvovaginitis, cytolytic vaginosis, aerobic vaginitis, and more.
For each of these conditions, the book presents information on its background, microbiology, immunology, prevention, diagnosis, and treatment. Therapy details are provided with an emphasis on nuances that can be applied to women who fail to respond to medication prescribed or who respond and then become symptomatic once treatment has ended.
This new edition discusses major advances in the characterization of endogenous microbiota that populate the genital tract in women of all ages. It also provides a more sophisticated appreciation of immune mechanisms found in the healthy female genital tract and alterations that increase both susceptibility and consequences of various infectious and noninfectious disorders. A major impetus for writing this new edition is to help the busy clinician, resident, or fellow by explaining advances in individual disorders in a manner that is relevant to their practice.
Features
Covers diagnosis and treatment of various vulvovaginal infections
Presents, for each condition, information on its background, microbiology, immunology, prevention, diagnosis, and treatment
Presents information on the microbiology of the vagina and vaginal immunology
Focuses on diagnosis and shortcomings with standard tests
Offers new information on the vaginal microbiome
Table of Contents
Microbiology of the Vagina
The Human Microbiome
Birth to Puberty
Reproductive Age Women
Pregnancy
Vulvar Microbiome
Postmenopause
The Uniqueness of the Human Vaginal Microbiome
Lactic Acid
Summary and Conclusions
References
Vaginal Immunology
Vaginal Epithelial Cell Immunity
Danger Signaling by Heat Shock Proteins
Antibody Production in the Lower Genital Tract
Sexual Intercourse and Vaginal Immunity
Summary and Conclusions
References
Diagnosis of Vulvovaginal Disease
Background
Physician Focus on the Patient
History
Office Equipment Requirements for Diagnosis
Physical Examination
Pelvic Examination
Laboratory Testing with Delayed Results
References
Candida Vulvovaginitis
Background
Microbiology
Immunology
Diagnosis
Treatment
References
Bacterial Vaginosis
Background
Microbiology
Immunology
Diagnosis
Treatment
References
Trichomonas vaginalis Vaginitis
Background
Microbiology
Immunology
Diagnosis
Treatment
References
Cytolytic Vaginosis, Aerobic Vaginitis, and Desquamative Inflammatory Vaginitis
Background
Microbiology
Immunology
Diagnosis
Treatment
References
Genital Herpes
Background
Microbiology
Immunology
Diagnosis
Treatment
References
Human Papillomavirus Genital Infections
Background
Microbiology
Immunology
Prevention
Diagnosis
Treatment
References
Other Sexually Transmitted Diseases of the Vulva and the Vagina
Background
Microbiology and Immunology
Diagnosis
Treatment
References
Allergic Vulvovaginitis
Background
Microbiology
Immunology
Diagnosis
Treatment
References
Menopausal Vulvovaginitis
Background
Microbiology
Immunology
Diagnosis
Treatment
References
Vestibulodynia
Background
Microbiology
Immunology
Diagnosis
Treatment
References
Dermatologic Disorders Causing Vulvar Disease
Background
Immunology and Microbiology
Lichen Sclerosus
Lichen Planus
Aphthous Ulcers and Behçet’s Disease
Pemphigus
Diagnosis
Inflammatory and Erosive Skin Disorders
Treatment
Psoriasis of the Vulva
References
William J. Ledger, MD, FACOG, obstetrician and gynaecologist in chief, New York Weill Cornell Center, New York, New York, USA
Steven S. Witkin, PhD, professor of immunology in obstetrics and gynecology, New York Weill Cornell Center, New York, New York, USA
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