ISSN 2398-2977      

Vagina: bacterial infection

pequis

Introduction

  • Bacterial vaginitis and cervicitis rarely occurs without endometritis.
  • Cause: pneumovagina, irritation, urine pooling, contamination, trauma, antibiotic therapy.
  • Signs: vaginal hyperemia, discharge.
  • Diagnosis: vaginoscopy, microbiology.
  • Treatment: correct underlying cause; treat endometritis if present.
  • Prognosis: good for uncomplicated vaginitis.

Pathogenesis

Etiology

  • Inflammation of the vagina subsequent to a number of predisposing conditions allows the establishment of secondary bacterial invaders, ieStreptococcus zooepidemicus Streptococcus spp, E. coli Escherichia coli.
  • Occasionally Clostridial or gram-negative anaerobes may lead to a necrotic vaginitis.
  • Venereal organisms such as Taylorella equigenitalis Taylorella equigenitalis and Klebsiella pneumoniae Klebsiella pneumoniae may cause vaginitis without predisposition.

Predisposing factors

General

  • Underlying conformational defect, eg pneumovagina Vagina: pneumovagina.
  • Dystocia Reproduction: dystocia or mating trauma.
  • Urine pooling Vestibule: urine pooling.
  • Irritation, eg uterine washes of irritant chemicals, hair/necrotic tissue following parturition/dytocia delivery.
  • Contaminated equipment.
  • Disruption of normal vaginal flora, eg by antibiotic therapy.
  • Rectovaginal/vestibular fistulas and 3rd degree perineal tears.
  • Urovagina.

Pathophysiology

  • Underlying defect allows contamination of vagina → vaginitis → usually extends to involve uterus.
  • Normal flora of vagina usually protects against pathogens, but includes species, such asStreptococcus zooepidemicus Streptococcus spp which will invade a compromised reproductive tract.
  • Compromise of vaginal defenses, eg due to air aspiration in pneumovagina Vagina: pneumovagina, trauma or irritation → vaginal hyperemia and exudate → may extend to cervix and/or uterus → cervicitis and endometritis.
  • Vaginitis may → cervicitis → cervical fibrosis → cervical adhesions or endometritis (acute, recurrent or chronic).
  • Severe vaginitis may lead to vaginal adhesions in occasional cases.
  • Prolonged manipulations during dystocia can cause vaginitis, cervicitis and consequent adhesions; this is a problem particularly in miniature horses

Timecourse

  • Usually chronic.

Epidemiology

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • LeBlanc M M (2008) Common peripartum problems in the mare. J Equine Vet Sci 28 (11), 709-715 VetMedResource.​​
  • Christoffersen M, Lehn-Jensen H & Bøgh I B (2007) Referred vaginal pain: Cause of hypersensitivity and performance problems in mares? A clinical case study. J Equine Vet Sci 27 (1), 32-36 VetMedResource.
  • Ley W B et al (1980) Salmonella-induced vaginitis. Vet Med Small Anim Clin 75 (9), 1417-1419 PubMed.
  • ​Jackson P S, Allen W R, Ricketts S W & Hall R (1979) The irritancy of chlorhexidine gluconate in the genital tract of the mare. Vet Rec 105 (6), 122-124 PubMed.

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