Cytolytic vaginosis occurs due to overgrowth of Lactobacillus species and subsequent lysis of epithelial cells in a highly acidic environment. Dysuria, dyspareunia and whitish discharge are main symptoms and the diagnosis is made based on microbiological findings from vaginal smears. Douching with sodium bicarbonate solutions to increase vaginal pH is the mainstay of therapy.
Presentation
The clinical presentation is strikingly similar to candidal vaginosis, characterized by dyspareunia, dysuria, abundant whitish discharge and pruritus [1] [2]. A cyclical appearance of symptoms, most likely during the luteal phase of the menstrual cycle is observed [1].
Entire Body System
- Candidiasis
The pH was 3.5 to 5.5 and the clinical symptoms were profuse vaginal discharge (VD) especially whitish-cheesy vaginal discharge and other symptoms of vaginal candidiasis. [unboundmedicine.com]
- Asymptomatic
However according to the CDC, 85 percent of women are asymptomatic (experience no symptoms). Symptoms Women 1. Gray/greenish discharge which may be frothy. 2. Discharge can have a fishy smell. 3. There may be itching and irritation. 4. [womens-health-advice.com]
Am J Obstet Gynecol 191:1124–1129 PubMed CrossRef Google Scholar Carey JC, Klebanoff MA (2001) Bacterial vaginosis and other asymptomatic vaginal infections in pregnancy. [link.springer.com]
Value of wet mount and cervical cultures at the time of cervical cytology in asymptomatic women. Obstetrics & Gynecology 1995;85:499-503. 29. Centers of Disease Control (CDC). [ispub.com]
Its most common symptoms are itching, urinary discomfort, perineal irritation, and whitish discharge in plates, while between 25% and 40% of women are asymptomatic (10). [scielo.br]
- Fatigue
Stay logged in ProHealth Fibromyalgia, ME/CFS and Lyme Disease Forums Forums Home Forums > Conditions > Fibromyalgia Forums > Fibromyalgia Main Forum > ProHealth Store | View Cart 800-366-6056 | Contact Us | Help Fibromyalgia Chronic Fatigue Syndrome [forums.prohealth.com]
She had chronic fatigue, recurrent yeast vaginal infections, itchy ears,.You can minimize its effects by following the yeast control eating program for a week or so before you start taking any Now I'd like to hear from you. [parnettic.eu]
【飛蚊症】*myodesopsia (百) 【百日咳】*whooping cough *pertussis 【標的赤血球増加症】*leptocytosis 【表皮炎】*epidermitis 【表皮下膿瘍】*subepidermal abscess 【表皮水疱症】*bullous epidermolysis *epidermolysis bullosa[L] (略 EB) 【表皮剥離】*epidermolysis 【疲労】*fatigue 【疲労骨折】*fatigue fracture *stress [medo.jp]
- Anemia
】*malignant ameloblastoma 【悪性高熱症】*malignant hyperthermia 【悪性黒色腫】*malignant melanoma (略 MM) 【悪性腫瘍】*malignant tumor *malignancy 【悪性新生物】*malignant neoplasm (=悪性腫瘍) 【悪性組織球症】*malignant histiocytosis (略 MH) 【悪性中皮腫】*malignant mesothelioma 【悪性貧血】*pernicious anemia [medo.jp]
Gastrointestinal
- Diarrhea
Other Types On the rare occasion vaginitis can result from a Shigella bacteria infection, although typically symptoms are more likely to be diarrhea, fever and stomach cramps. [womens-health-advice.com]
Acyclovir, valacyclovir, and famciclovir have similar side effects, which include nausea, vomiting, headache, and diarrhea. [sh.lsuhsc.edu]
Diarrhea, bloating, gas, nausea, burning, redness, itching everywhere, skin rash called(Pityrosporum Foliculitis). My immune system will not try and fight off any yeast, molds or mildews. The only treatment is antifungal therapy. [curezone.org]
Tasty and no more diarrhea! God Bless Earth Clinic! " [filtrations4.rssing.com]
[…] dermatitis 【アナフィラキシー】*anaphylaxis 【アフタ】*aphtha (形 *aphthous) 【アフタ性咽頭炎】*aphthous pharyngitis 【アフタ性潰瘍】 *aphthous ulcer 【アフタ性口内炎】 *aphthous stomatitis 【アフタ性歯肉炎】 *aphthous gingivitis 【アミロイド症】【アミロイドーシス】*amyloidosis =類澱粉沈着症 【アメーバ症】*amebiasis 【アメーバ性下痢】*amebic diarrhea [medo.jp]
- Nausea
Acyclovir, valacyclovir, and famciclovir have similar side effects, which include nausea, vomiting, headache, and diarrhea. [sh.lsuhsc.edu]
Diarrhea, bloating, gas, nausea, burning, redness, itching everywhere, skin rash called(Pityrosporum Foliculitis). My immune system will not try and fight off any yeast, molds or mildews. The only treatment is antifungal therapy. [curezone.org]
[…] neoplasm (=悪性腫瘍) 【悪性組織球症】*malignant histiocytosis (略 MH) 【悪性中皮腫】*malignant mesothelioma 【悪性貧血】*pernicious anemia 【悪性黒子】*lentigo maligna[L] 【悪性黒子黒色腫】*lentigo maligna melanoma (略 LMM) 【悪性傍神経節腫】*malignant paraganglioma 【悪性リンパ腫】*malignant lymphoma 【悪心】*nausea [medo.jp]
- Vomiting
Acyclovir, valacyclovir, and famciclovir have similar side effects, which include nausea, vomiting, headache, and diarrhea. [sh.lsuhsc.edu]
/*vomition/*vomitus *emesis (カ) 【カタル性胃炎】*catarrhal gastritis 【カタル性炎】*catarrhal inflammation 【カタル性舌炎】*catarrhal glossitis *glossitis catarrhalis[L] 【カフェオーレ斑】*cafe-au-lait spot 【カポジ肉腫】*Kaposi's sarcoma 【カリウム血症】*kalemia 【カリウム欠乏症】*kaliopenia 【カリニ肺炎】*pneumocystis [medo.jp]
- Polydipsia
苔癬様皮膚症】【苔癬様皮膚病】*lichenoid dermatosis (退)* 【退行形成】【退形成】*retroplasia *anaplasia 【退縮眼振】*retractory nystagmus *nystagmus of retraction (太) 【太鼓バチ状指】【太鼓バチ指】*clubbed finger =バチ状指、バチ指 (代) 【代謝疾患】*metabolic disease (体) 【体静脈狭窄】*systemic vein stenosis (多) 【多飲多食症】*polydipsia [medo.jp]
Skin
- Pruritus
Cytolytic vaginosis is characterized by pruritus, dyspareunia, vulvar dysuria, and cyclical increase in symptoms more pronounced during the luteal phase. [ncbi.nlm.nih.gov]
The clinical presentation is strikingly similar to candidal vaginosis, characterized by dyspareunia, dysuria, abundant whitish discharge and pruritus. [symptoma.com]
It has been associated with the following symptoms: Abundant whitish vaginal discharge, which may be thin and watery or thick and curd-like Vaginal and/or vulval itching ( pruritus vulvae ) Burning ( vulvodynia ), especially on passing urine ( dysuria [dermnetnz.org]
However, they may have the following symptoms: Abundant whitish vaginal discharge, which may be thin and watery or thick and curd-like Vaginal and/or vulval itching ( pruritus vulvae ) Burning ( vulvodynia ), especially on passing urine ( dysuria ) Discomfort [reprosait4u.blogspot.com]
Neurologic
- Irritability
Temporary irritation inside the penis. 2. Slight burning after ejaculation or urination. [womens-health-advice.com]
Baking soda sitz baths help soothe my irritation/pain, but haven't gotten rid of my CV symptoms. When the area is feeling particularly itchy or irritated, the gabapentin cream makes it feel much better. [steadyhealth.com]
[…] of vaginitis is to avoid any of the common irritants above. [reneecottermd.com]
Oral sex should also be avoided during symptomatic periods because bacteria in the partner's mouth may be irritating to the vulva. [encognitive.com]
- Burning Sensation
The symptoms of Cytolytic Vaginosis are genital area itching, a burning sensation on passing urine, excessive white discharge occasionally with a slight odour. These symptoms can tend to worsen in the second half of the menstrual cycle. [vaginosisinfo.com]
sensation when urinating. plus, all other tests coming back negative for BV yeast, etc. my question to you is, if i were to go ahead and treat myself for this using baking soda douches, and i DIO NOT have Cytolytic Vaginosis, will doing so really mess [medhelp.org]
About a week after I stopped taking the doxycycline I had sex for the first time since starting the medication and the morning after I experienced a raw, burning sensation and discomfort. [mumsnet.com]
Clinical characteristics described in 1952 by Feo and Dellette included a white discharge varying from slight to moderate in amount, vulvar itching, and a burning sensation over the introital area following urination ( 23 ). [ispub.com]
- Tremor
[…] hepatitis 【中毒性肝硬変】*toxic liver cirrhosis/*toxic cirrhosis 【中毒性巨大結腸症】*toxic megacolon 【中毒性結節】*toxic nodule 【中毒性紅斑】*toxic erythema 【中毒性疾患】*toxic disease *nosotoxicosis 【中毒性湿疹】*toxic eczema 【中毒性ショック】*toxic shock 【中毒性ショック症候群】*toxic shock syndrome 【中毒性振戦】*toxic tremor [medo.jp]
Urogenital
- Vaginal Discharge
METHODS: Fungal cultures, 10% potassium hydroxide (KOH) and Gram stained preparations and pH measurements were performed on the vaginal discharge material of each patient. [ncbi.nlm.nih.gov]
The pH was 3.5 to 5.5 and the clinical symptoms were profuse vaginal discharge (VD) especially whitish-cheesy vaginal discharge and other symptoms of vaginal candidiasis. [unboundmedicine.com]
Vaginal discharge is white and tends to be thick or pasty 3. Thew it no odd associated with (he discharge. If a whiff test is performed it is negative 4. The vaginal epithelium can appear slightly erythematous 5. pH 4.5 6. [sexualhealthmedicine.com]
- Dyspareunia
The clinical presentation is strikingly similar to candidal vaginosis, characterized by dyspareunia, dysuria, abundant whitish discharge and pruritus. [symptoma.com]
Cytolytic vaginosis is characterized by pruritus, dyspareunia, vulvar dysuria, and cyclical increase in symptoms more pronounced during the luteal phase. [ncbi.nlm.nih.gov]
[…] symptoms: Abundant whitish vaginal discharge, which may be thin and watery or thick and curd-like Vaginal and/or vulval itching ( pruritus vulvae ) Burning ( vulvodynia ), especially on passing urine ( dysuria ) Discomfort during sexual intercourse ( dyspareunia [reprosait4u.blogspot.com]
Thus, in this patient, the presence of vulvovaginal itching and dyspareunia along with the examination findings of a erythematous vaginal mucosa are most suggestive of vaginitis. [prognosisapp.com]
- Dysuria
The clinical presentation is strikingly similar to candidal vaginosis, characterized by dyspareunia, dysuria, abundant whitish discharge and pruritus. [symptoma.com]
Cytolytic vaginosis is characterized by pruritus, dyspareunia, vulvar dysuria, and cyclical increase in symptoms more pronounced during the luteal phase. [ncbi.nlm.nih.gov]
However, they may have the following symptoms: Abundant whitish vaginal discharge, which may be thin and watery or thick and curd-like Vaginal and/or vulval itching ( pruritus vulvae ) Burning ( vulvodynia ), especially on passing urine ( dysuria ) Discomfort [reprosait4u.blogspot.com]
It has been associated with the following symptoms: Abundant whitish vaginal discharge, which may be thin and watery or thick and curd-like Vaginal and/or vulval itching ( pruritus vulvae ) Burning ( vulvodynia ), especially on passing urine ( dysuria [dermnetnz.org]
- Cheesy Vaginal Discharge
The pH was 3.5 to 5.5 and the clinical symptoms were profuse vaginal discharge (VD) especially whitish-cheesy vaginal discharge and other symptoms of vaginal candidiasis. [unboundmedicine.com]
The women presenting with cytolytic vaginosis complain of a thick or thin white cheesy vaginal discharge, pruritus, dyspareunia, vulvar dysuria, and a cyclic increase in symptoms that are more pronounced in the luteal phase ( 11, 37, 49 ). [ispub.com]
- Pruritus Vulvae
It has been associated with the following symptoms: Abundant whitish vaginal discharge, which may be thin and watery or thick and curd-like Vaginal and/or vulval itching ( pruritus vulvae ) Burning ( vulvodynia ), especially on passing urine ( dysuria [dermnetnz.org]
However, they may have the following symptoms: Abundant whitish vaginal discharge, which may be thin and watery or thick and curd-like Vaginal and/or vulval itching ( pruritus vulvae ) Burning ( vulvodynia ), especially on passing urine ( dysuria ) Discomfort [reprosait4u.blogspot.com]
Workup
A presumptive diagnosis can be made based on clinical findings and reported complaints, but because numerous pathogens may cause a similar presentation, it is necessary to perform a vaginal smear and subsequent microscopic examination [1]. The proposed criteria for cytolytic vaginosis are evidence of cytolysis, abundance of lactobacilli, absence of Trichomonas vaginalis, Gardnerella vaginalis or Candida sp. on wet smear and pH of the smear between 3.5-4.5 [4].
Serum
- Cytolytic Vaginosis
Cytolytic vaginosis occurs due to overgrowth of Lactobacillus species and subsequent lysis of epithelial cells in a highly acidic environment. [symptoma.com]
Cytolytic Vaginosis also know as, cytolytic vaginitis, cytolysis vaginosis, cytolysis vaginitis, Doderlein’s cytolysis is not an infection. [vaginosisinfo.com]
Abstract Cytolytic vaginosis, a not uncommon condition, is frequently misdiagnosed because it is confused with Candida. [ncbi.nlm.nih.gov]
Cytolytic vaginosis, also referred to as Doderlein cytolysis, appears to be a common alteration in the vaginal ecosystem. Cytolytic vaginosis is similar in gross appearance to the discharge that is seen with vaginal candidiasis. [sexualhealthmedicine.com]
Microbiology
- Candida
The smears were assessed for the quantity of lactobacilli, epithelial cell morphology, and the absence or presence of Candida species, Trichomonas vaginalis, and clue sells. [ncbi.nlm.nih.gov]
The proposed criteria for cytolytic vaginosis are evidence of cytolysis, abundance of lactobacilli, absence of Trichomonas vaginalis, Gardnerella vaginalis or Candida sp. on wet smear and pH of the smear between 3.5-4.5. [symptoma.com]
Previously we reported that oral epithelial cell anti- Candida activity is reduced in... [connection.ebscohost.com]
Indentify CV and VVC based on the quantity of lactobacilli, epithelial cell morphology, and the absence or presence of Candida species and other pathogens. [journals.lww.com]
- Gram-Positive Rods
Definition / general Presence of gram positive rods (lactobacilli) with cytolysis of intermediate cells Terminology Also known as bacillus vaginalis, bacillus Doderlein Epidemiology Lactobacilli are the most abundant bacteria found in normal vaginal flora [pathologyoutlines.com]
rods, now referred as lactobacillus species. [ncbi.nlm.nih.gov]
Historical Perspectives In 1892, Doderlein first identified the presence or absence of gram-positive rods in normal vaginal flora ( 16 ). He named these organisms Doderlein's bacilli. [ispub.com]
- Gram-Positive Bacteria
Clindamycin will also have an inhibitory effect on Gram-positive bacteria, except the enterococci. Additionally, clindamycin would not have a suppressive effect on the Gram-negative facultative bacteria. [sexualhealthmedicine.com]
Treatment
Once the diagnosis is confirmed, the main goal of therapy is elevation of vaginal pH through douching with sodium bicarbonate solution or through the use of a vaginal sodium bicarbonate suppository [1] [4]. In most cases, intravaginal douching is performed for twice weekly for 2-3 weeks, while antibiotic therapy is not necessary [1].
Prognosis
The condition is self-limiting and easy to treat, but the diagnosis is often made erroneously as chronic candidal vulvovaginitis that does not respond to therapy [3], which is why the diagnostic workup should be properly conducted [2] [6].
Etiology
Lysis of vaginal epithelial cells is caused by overgrowth of lactobacilli, but the exact cause remains unclear [2].
Epidemiology
The exact rates of this condition in women is unknown, but cytolytic vaginosis is almost exclusively encountered in women during childbearing age [2]. Because lactobacilli convert glucose to lactic acid, it is hypothesized that women suffering from diabetes mellitus are more prone to this condition due to a higher circulating level of glucose [1].
Pathophysiology
Under physiological conditions, Lactobacilllus species provide numerous beneficial effects as normal vaginal flora, predominantly by acidification of the local environment through production of lactic acid from glucose and the influence of estrogen [1]. An additional function is the production of hydrogen peroxide (H2O2), a potent free radical that prevents the ability of pathogenic microogranisms, such as Escherichia coli, Gardnerella vaginalis, but also Candida sp., to grow and cause an infection [2] [5]. Competition for nutrients and secretion of acidolin, which also inhibits growth of other organisms, are additional mechanism of protection [2]. In some women during reproductive age, however, a phenomenon of Lactobacillus overgrowth in this environment can occur and cause lysis of vaginal epithelial cells due to excessive acidification [1].
Prevention
Apart from adequate hygiene, no other preventive measures are currently known regarding prevention of vaginal infections.
Summary
Cytolytic vaginosis is a term that describes lysis of vaginal epithelial cells as a result of abundant growth of Lactobacillus sp., which normally reside in the vagina as normal flora [1]. As a protective mechanism against harmful pathogens, lactobacilli produce hydrogen peroxide (H2O2) and preserve the vaginal microenvironment, but for still undisclosed reasons, abundant growth of this bacterial organism can occur in women during childbearing age and cause marked lysis of epithelial cells, primarily due to profound acidification during the process of glucose conversion to lactic acid [1]. The clinical presentation includes dysuria, whitish discharge, dyspareunia and pruritus, with symptoms most commonly appearing in cyclic fashion [1] [2]. To make the diagnosis, it is necessary to obtain a vaginal smear and perform a microscopic examination that will exclude other pathogens that present with similar complaints, most notable being Trichomonas vaginalis, Gardnerella vaginalis and Candida species [3] [4]. Cytolytic vaginosis is treated by increasing pH, most commonly through the use of sodium bicarbonate, either in the form of vaginal suppositories or douching [1].
Patient Information
Cytolytic vaginosis is a condition characterized by overgrowth of Lactobacillus species, which normally comprise normal vaginal flora and protect from various harmful microorganisms via several mechanisms. For some reason, abundant growth of this bacteria reduces normal pH of the vagina, causing a profoundly acidic environment in which destruction of epithelial cells (cytolysis) occurs. Symptoms such as painful urination, itching, whitish discharge and pain during intercourse are most frequently reported. This condition is almost exclusively seen in women during childbearing age and symptom often appear in cyclical fashion. The diagnosis can be made by obtaining a vaginal swab for microscopic examination. Increasing vaginal pH is the main principle of therapy, which is achieved by douching with sodium bicarbonate or use of vaginal suppositories containing sodium bicarbonate for 2-3 weeks. Cytolytic vaginosis is self-limiting and does not pose a risk for women, but it is often not recognized due to striking similarities of more common conditions such as vulvovaginitis caused by Candida, which is why careful examination is necessary to make the right diagnosis.
References
- Suresh A, Rajesh A, Bhat RM, Rai Y. Cytolytic vaginosis: A review. Indian J Sex Transm Dis. 2009;30(1):48-50.
- Cerikcioglu N, Beksac MS. Cytolytic vaginosis: misdiagnosed as candidal vaginitis. Infect Dis Obstet Gynecol. 2004;12(1):13-16.
- Hu Z, Zhou W, Mu L, Kuang L, Su M, Jiang Y. Identification of cytolytic vaginosis versus vulvovaginal candidiasis. J Low Genit Tract Dis. 2015;19(2):152-155.
- Cibley LJ, Cibley LJ. Cytolytic vaginosis. Am J Obstet Gynecol. 1991;165(4 Pt 2):1245-1249.
- Hillier SL, Krohn MA, Klebanoff SJ, Eschenbach DA. The relationship of hydrogen peroxide-producing lactobacilli to bacterial vaginosis and genital microflora in pregnant women. Obstet Gynecol. 1992;79(3):369-373.
- Demirezen S. Cytolytic vaginosis: examination of 2947 vaginal smears. Cent Eur J Public Health. 2003;11(1):23-24.