Aerobic Vaginitis - A Common but Underdiagnosed Cause of Recurrent Vaginal Discharge of Dysbiotic Origin - Are We Dealing with a Cryptic STI?
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Abstract
Background: Hitherto, the concept of vaginal dysbiosis was considered synonymous with Bacterial Vaginosis (BV), characterized by homogenous non-inflammatory vaginal discharge (VD) attributed to the replacement of the normal vaginal flora with pathological bacteria especially Gardnerella vaginalis. Across the globe, any woman in her 3rd to 4th decade of married life presenting with white homogenous minimally symptomatic VD was labelled as BV on finding of reduced lactobacilli, and often the fulfillment of the Amsel’s criteria. However, off late many women with inflammatory variant of BV with recurrence have started presenting to the STI clinic. An inflammatory variant of vaginal dysbiosis caused by group-B streptococci and related organisms presenting with purulent discharge and features of local inflammation was identified in 2002 and labelled aerobic vaginitis (AV) by Gilbert Donders. However, 17 years down the lane, this entity, suspected to be common, remains unknown to with consequential underdiagnosis by reproductive tract infection (RTI) specialists, gynecologists and dermatologists.
Introduction: Commensal microbiota related with the human body effect many features of fetal growth, physiological role, immunity at mucosal surfaces, susceptibility to infections and capacity to integrate nutrients. As such, commensals in the lower female reproductive tract are important in upholding vaginal health as well precluding infections.
Human vaginal infections are related with pointedly enlarged risk of preterm birth in women., On the off chance that untreated, they can prompt to pelvic inflammatory diseases (PID), which can cause tubal infertility, ectopic pregnancy, regenerative brokenness, and unfavorable pregnancy results (counting preterm conveyance and low birth weight). Vaginal diseases may add to the movement of cervical dysplasia, expanded danger of post-conveyance contaminations, HIV, and herpes simplex infection 2 (HSV-2) securing and transmission. In any case, the surprising pregnancy result and untimely birth because of vigorous vaginitis (AV) and bacterial vaginosis (BV) contaminations in pre-birth health administrations among asymptomatic pregnant ladies is high in Africa and around the world.
