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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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A woman may have vaginal itching or burning and may notice a discharge.
The discharge may be excessive in amounts or abnormal in color(such as yellow, gray, or green).
The following symptoms may indicate the presence of infection:
- Irritation or itching of the genital area
- inflammation (irritation, redness, and swelling caused by the presence of extra immune cells) of the labia majora, labia minora, or perineal area
- vaginal discharge
- foul vaginal odor
- pain/irritation with sexual intercourse
Vaginitis is inflammation of the vagina. In most cases, it is a symptom of an infection of the vagina. Vulvovaginitis, is an inflammation of the vagina and vulva. Infection can result in discharge, itching and pain.
The three main causes of vaginitis are infections by bacteria (bacterial vaginosis), yeast (vaginal candidiasis), or the protozoan that causes trichomoniasis. A woman may have multiple infections at any one time. If there is discomfort in the vulvovaginal area, women can request their health care providers evaluate for the presence of an infection.
A vaginal obstruction is often caused by an imperforate hymen or, less commonly, a transverse vaginal septum. A sign of vaginal obstruction is hydrocolpos, that is, accumulation of watery fluid within the vagina. It may extend to become "hydrometrocolpos", that is, accumulation of watery fluid within the vagina as well as within the uterus.
Women with aerobic vaginitis usually present with a thinned reddish vaginal mucosa, sometimes with extensive erosions or ulcerations and abundant yellowish discharge (without the fishy amine odour, typical of bacterial vaginosis). The pH is usually high. Symptoms can include burning, stinging and dyspareunia. The symptoms can last for long periods of time—sometimes even years. Typically, patients have been treated several times with antimycotic and antibiotic drugs without relief. In asymptomatic cases, there is microscopic evidence but no symptoms. The prevalence of asymptomatic cases is unknown.
Vaginismus, which is not the same thing as vaginitis (an inflammation of the vagina), is an involuntary tightening of the vagina due to a conditioned reflex of the muscles in the area during vaginal penetration. It can affect any form of vaginal penetration, including sexual intercourse, insertion of tampons and menstrual cups, and the penetration involved in gynecological examinations. Various psychological and physical treatments are possible to help alleviate it.
It may also result from inflammation or congestion of the vaginal mucosa. In cases where it is yellowish or gives off an odor, a doctor should be consulted since it could be a sign of several disease processes, including an organic bacterial infection (aerobic vaginitis) or STD.
After delivery, leukorrhea accompanied by backache and foul-smelling lochia (post-partum vaginal discharge, containing blood, mucus, and placental tissue) may suggest the failure of involution (the uterus returning to pre-pregnancy size) due to infection. A number of investigation such as wet smear, Gram stain, culture, pap smear and biopsy are suggested to diagnose the condition.
Leukorrhea or (leucorrhoea British English) is a thick, whitish or yellowish vaginal discharge. There are many causes of leukorrhea, the usual one being estrogen imbalance. The amount of discharge may increase due to vaginal infection or STDs, and it may disappear and reappear from time to time. This discharge can keep occurring for years, in which case it becomes more yellow and foul-smelling. It is usually a non-pathological symptom secondary to inflammatory conditions of vagina or cervix.
Leukorrhea can be confirmed by finding >10 WBC under a microscope when examining vaginal fluid.
Vaginal discharge is not abnormal, and causes of change in discharge include infection, malignancy, and hormonal changes. It sometimes occurs before a girl has her first period, and is considered a sign of puberty.
Vulvitis, inflammation of the vulva, can have a variety of etiologies in children and adolescents, including allergic dermatitis, contact dermatitis, lichen sclerosus, and infections with bacteria, fungi, and parasites. Dermatitis in infants is commonly caused by a soiled diaper being left on for an extended period of time. Increasing the frequency of diaper changes and topical application of emollients are sufficient to resolve most cases. Dermatitis of the vulva in older children is usually caused by exposure to an irritant (e.g. scented products that come into contact with the vulva, laundry detergent, soaps, etc.) and is treated with preventing exposure and encouraging sitz baths with baking soda as the vulvar skin heals. Other treatment options for vulvar dermatitis include oral hydroxyzine hydrochloride or topical hydrocortisone.
Lichen sclerosus is another common cause of vulvitis in children, and it often affects an hourglass or figure eight-shaped area of skin around the anus and vulva. Symptoms of a mild case include skin fissures, loss of skin pigment (hypopigmentation), skin atrophy, a parchment-like texture to the skin, dysuria, itching, discomfort, and excoriation. In more severe cases, the vulva may become discolored, developing dark purple bruising (ecchymosis), bleeding, scarring, attenuation of the labia minora, and fissures and bleeding affecting the posterior fourchette. Its cause is unknown, but likely genetic or autoimmune, and it is unconnected to malignancy in children. If the skin changes are not obvious on visual inspection, a biopsy of the skin may be performed to acquire an exact diagnosis. Treatment for vulvar lichen sclerosus may consist of topical hydrocortisone in mild cases, or stronger topical steroids (e.g. clobetasol propionate). Preliminary studies show that 75% of cases do not resolve with puberty.
Organisms responsible for vulvitis in children include pinworms ("Enterobius vermicularis"), "Candida" yeast, and group A hemolytic "Streptococcus". Though pinworms mainly affect the perianal area, they can cause itching and irritation to the vulva as well. Pinworms are treated with albendazole. Vulvar "Candida" infections are uncommon in children, and generally occur in infants after antibiotic therapy, and in children with diabetes or immunodeficiency. "Candida" infections cause a red raised vulvar rash with satellite lesions and clear borders, and are diagnosed by microscopically examining a sample treated with potassium hydroxide for hyphae. They are treated with topical butoconazole, clotrimazole, or miconazole. "Streptococcus" infections are characterized by a dark red discoloration of the vulva and introitus, and cause pain, itching, bleeding, and dysuria. They are treated with antibiotics.
Aerobic vaginitis has been associated with several gynecological and obstetrical complications, including:
- Premature rupture of membranes
- Preterm labour
- Ascending chorioamnionitis.
- Increased risk to acquire sexually transmitted infections (including HIV)
- Abnormal Pap test results
Vulvitis is inflammation of the vulva, the external female mammalian genitalia that include the labia majora, labia minora, clitoris, and introitus (the entrance to the vagina). It may co-occur with vaginitis, inflammation of the vagina, and may have infectious or non-infectious causes.
Genital symptoms include dryness, itching, burning, soreness, pressure, white discharge, malodorous discharge due to infection, painful sexual intercourse, bleeding after intercourse. In addition, sores and cracks may occur spontaneously. Atrophic vaginitis is one possible cause of postmenopausal bleeding (PMB).
Urinary symptoms include painful urination, blood in the urine, increased frequency of urination, incontinence, and increased likelihood and occurrence of infections.
Atrophic vaginitis (also known as vaginal atrophy, vulvovaginal atrophy, or urogenital atrophy) is an inflammation of the vagina (and the outer urinary tract) due to the thinning and shrinking of the tissues, as well as decreased lubrication. These symptoms are due to a lack of the reproductive hormone estrogen.
The most common cause of vaginal atrophy is the decrease in estrogen which happens naturally during perimenopause, and increasingly so in post-menopause. However this condition can occur in other circumstances that result in decreased estrogen such as breastfeeding and the use of medications intended to decrease estrogen too, for example, treat endometriosis.
The symptoms can include vaginal soreness and itching, as well as painful intercourse, and bleeding after sexual intercourse. The shrinkage of the tissues and loss of flexibility can be extreme enough to make intercourse impossible.
The most obvious symptom of open pyometra is a discharge of pus from the vulva in a female that has recently been in heat. However, symptoms of closed pyometra are less obvious. Symptoms of both types include vomiting, loss of appetite, depression, and increased drinking and urinating. Fever is seen in less than a third of female dogs with pyometra. Closed pyometra is a more serious condition than open pyometra not only because there is no outlet for the infection, but also because a diagnosis of closed pyometra can easily be missed due to its insidious nature. Bloodwork may show dehydration and/or increased white blood cell count. X-rays will show an enlarged uterus, and ultrasound will confirm the presence of a fluid filled uterus.
Pyometra or pyometrea is a uterine infection. Though it is most commonly known as a disease of the unaltered female dog, it is also a notable human disease. It is also seen in female cattle, horses, goats, sheep, swine, cats (queens), rabbits, hamsters, ferrets, rats and guinea pigs. Pyometra is an important disease to be aware of for any dog owner because of the sudden nature of the disease and the deadly consequences if left untreated. It has been compared to acute appendicitis in humans, because both are essentially empyemas within an abdominal organ.
One of the most common areas of the body associated with irritation is the vagina. Many women complain of an itch, dryness, or discharge in the perineum at some point in their lives. There are several causes of vaginal irritation including fungal vaginitis (like candida) or trichomoniasis. Often, herpes simplex infection of the mouth or genitalia can be recurrent and prove to be extremely irritating.
Sometimes, the irritation can be of the chronic type and it can be so intense that it also causes painful intercourse. Aside from infections, chronic irritation of the vagina may be related to the use of contraceptives and condoms made from latex. The majority of contraceptives are made of synthetic chemicals which can induce allergies, rash and itching. Sometimes the lubricant used for intercourse may cause irritation.
Another cause of irritation in women is post menopausal vaginitis. The decline in the female sex hormones leads to development of dryness and itching in the vagina. This is often accompanied by painful sexual intercourse. Cracks and tears often develop on outer aspects of the labia which becomes red from chronic scratching. Post menopausal vaginitis can be treated with short term use of vaginal estrogen pessary and use of a moisturizer.
The first symptom is a sudden onset of swelling of the face, which develops within two days into papules and pustues on the lips, nose, and around the eyes. These pustules release a purulent discharge, causing a crust to form on the skin. There is also lymphadenopathy (swelling of lymph nodes) in the main lymph nodes of the head. The feet, body, prepuce or perianal area may be affected. Pustular otitis externa can occur, with the pinnae (ear flaps) becoming thickened by edema. Affected areas are painful but not itchy. Approximately half of affected puppies have lethargy and depression. Less common symptoms include pyrexia, anorexia, and joint pain, caused by sterile suppurative arthritis.
Gastritis or stomach upset is a common irritating disorder affecting millions of people. Gastritis is basically inflammation of the stomach wall lining and has many causes. Smoking, excess alcohol consumption and the use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, account for the majority of causes of gastritis. In some cases, gastritis may develop after surgery, a major burn, infection or emotional stress. The most common symptoms of gastritis include sharp abdominal pain which may radiate to the back. This may be associated with nausea, vomiting, abdominal bloating and a lack of appetite. When the condition is severe it may even result in loss of blood on the stools. The condition often comes and goes for years because most people continue to drink alcohol or use NSAIDs. Treatment includes the use of antacids or acid neutralizing drugs, antibiotics, and avoiding spicy food and alcohol.
Puppies are first presented with what appears to be staphylococcal pyoderma. Definitive diagnosis requires cytologic and histopathologic evaluations. Cytologic examination of papulopustular lesions of juvenile cellulitis reveals pyogranulomatous inflammation with no microorganisms and carefully performed cultures are negative. Biopsies of early lesions reveal multiple discrete or confluent granulomas and pyogranulomas consisting of clusters of large epithelioid macrophages with variably sized cores of neutrophils. Cytological analysis of joint fluid often reveals sterile suppurative arthritis.
A hot spot, or "acute moist dermatitis", is an acutely inflamed and infected area of skin irritation created and made worse by a dog licking and biting at itself. A hot spot can manifest and spread rapidly in a matter of hours as secondary Staphylococcus infection causes the top layers of the skin to break down and as pus becomes trapped in the hair. Hot spots can be treated with corticosteroid medications and oral as well as topical antibiotic application, as well as clipping hair from around the lesion. Underlying inciting causes include flea allergy dermatitis, ear disease or other allergic skin diseases. Dogs with thick undercoat are most subject to getting hot spots.
Skin disease may result from deficiency or overactivity of immune responses. In cases where there is insufficient immune responses the disease is usually described by the secondary disease that results. Examples include increased susceptibility to demodectic mange and recurrent skin infections, such as Malassezia infection or bacterial infections. Increased, but harmful immune responses, can be divided into hypersensitivity disorders such as atopic dermatitis, and autoimmune disorders (autoimmunity), such as pemphigus and discoid lupus erythematosus.
In humans, this parasitic infection causes a variety of symptoms, depending on where the cyst occurs. The tapeworm larvae group together to form fluid filled cysts in various body tissues. These cysts start out small, but as the larvae grow, the cyst can reach the size of an egg. The cysts of "T. multiceps" are usually between 2 and 6 cm in diameter and are most commonly found in the CNS and can contain anywhere from a few to over a hundred worm larvae within them. "T serialis" and "T. glomerata" cysts present in the CNS, muscles, or subcutaneous tissue, and "T. brauni" cysts occupy these same areas but occur in the eye more frequently than the other three species.
When the cyst occurs in the brain, as it often does, the infected individual may experience headaches, seizures, vomiting, paralysis affecting one side of the body (hemiplegia), paralysis involving one limb (monoplegia), and loss of ability to coordinate muscles and muscle movements. Many of these symptoms are due to the buildup of inter-cranial pressure from the growing cyst or from the cyst pressing on other parts of brain.
When the cyst occurs in the spinal cord, it can cause severe pain and inflammation, and loss of feeling in some nerves.
When the cyst occurs in the eyes, it causes decreased vision and headaches.
In the muscular and subcutaneous tissues, the cyst causes disfiguring nodules that can protrude out of the body. These nodules can be painful, uncomfortable, and can cause loss of muscle function.
Coenurosis is a parasitic infection that results when humans ingest the eggs of dog tapeworm species "Taenia multiceps", "T. serialis, T. brauni," or "T. glomerata."
It is important to distinguish that there is a very significant difference between intestinal human tapeworm infection and human coenurosis. Humans are the definitive hosts for some tapeworm species, the most common being "T. saginata" and "T. solium" (beef and pork tapeworms). This means that these species can develop into full grown, reproductively capable adult worms within the human body. People infected with these species have a tapeworm infection. In contrast, the four species that cause human coenurosis can only grow into mature, reproductively capable worms inside their definitive hosts, canids such as dogs, wolves, foxes and coyotes. Humans who ingest eggs from any of these four species of "Taenia" become intermediate hosts, or places where the eggs can mature into larvae but not into adult worms. When humans ingest these eggs, the eggs develop into tapeworm larvae that group within cysts known as coenuri, which can be seen in the central nervous system, muscles, and subcutaneous tissues of infected humans. People with coenurosis do not develop a tapeworm infection because the larvae of coenurosis-causing parasites cannot develop into worms inside of humans.
Self-healing juvenile cutaneous mucinosis is a skin condition caused by fibroblasts producing abnormally large amounts of mucopolysaccharides, and is characterized by the sudden onset of skin lesions and polyarthritis.
Cutaneous
- Alopecia
- Skin lesions
- Ulcerative or exfoliative dermatitis
Visceral
- Epistaxis (nose bleeds)
- Kidney failure > increased urination and drinking
- Ocular signs
- Progressive loss of weight with decreased appetite
- Swollen lymphnodes
Sylvatic plague is an infectious bacterial disease caused by the bacterium "Yersinia pestis" that primarily affects rodents such as prairie dogs. It is the same bacterium that causes bubonic and pneumonic plague in humans. Sylvatic, or sylvan, means 'occurring in wildlife,' and refers specifically to the form of plague in rural wildlife. Urban plague refers to the form in urban wildlife.
It is primarily transmitted among wildlife through flea bites and contact with infected tissue or fluids. Sylvatic plague is most commonly found in prairie dog colonies and some mustelids like the black-footed ferret.