![]() According to Horowitz et al, the symptoms occur regularly, are most apparent in the progestinic phase of the menstrual cycle and more manifested before menses. The constant cleaning of the perineal area is very annoying to these patients. Clinical DiagnosisĬlinically VL is manifested by profuse although variable white vaginal discharge, at times vulvar itching, a burning feeling in the vaginal introitus that follows urination, and the sensation of incessantly having wet the underwear. The prevalence of VL according to Feo et al is around 15% in patients who complain about abundant vaginal discharge. They suggested that patients with diabetes mellitus could be more prone to developing lactobacillosis since lactobacilli are more abundant in women with high serum glucose levels. Īnother thought-provoking correlation was found by Korenek et al between diabetes mellitus and lactobacillosis. This may contribute to the damage of epithelial cells, nerve endings, and receptors therefore serving as a risk factor for the development of vulvodynia. It is interesting to note that Ricci et al postulated the hypothesis that lactobacillosis causes an increased production of lactic acid and hydrogen peroxide. Ferris et al have postulated that increased availability of OTC anti-fungals misused by self-diagnosed fungal infections may be contributing to the transformation of normal lactobacilli. The cause of VL is mysterious and several authors like Kaufman and Faro have stated that since the organism behaves commensally, lacking evidence to the contrary, it may safely be ignored. Abundant, long, segmented lactobacilli chains (also known as leptothrix), ranging between 40 and 75 µm in length (× 600).įigure 3. Abundant and extremely longer than normal lactobacilli in vaginal wet mount preparation (× 400).įigure 2. A normal wet mount preparation is illustrated in Figure 3 as a comparison.įigure 1. Patients with VL have abundant, long, segmented lactobacilli chains (also known as leptothrix), ranging between 40 and 75 µm in length as seen in Figure 2. In asymptomatic women vaginal lactobacilli usually measure between 5 and 15 µm in length, as seen in Figure 1. VL is a condition characterized by the presence of extremely long lactobacilli in vaginal wet mount preparations. coli, Gardnerella vaginalis and Mobilincus species and could also protect against human immunodeficiency virus infection. Hydrogen peroxide suppresses the growth of Gram-negative and Gram-positive facultative and obligate anerobes, including such organisms as E. Additionally a recently identified bacteriocin, lactocin 160, targets the cytoplasmic membrane of Gardnerella vaginalis. Lactic acid inhibits the growth of bacterial vaginosis species and N. Lactobacilli also exert their inhibition by producing bacteriocins, hydrogen peroxide, and lactic acid that function as antibacterials. They exert their inhibition by several mechanisms, including competing for binding receptors on vaginal epithelial cells thus hindering pathologic microorganisms from adhering. These bacteria are responsible for maintaining a healthy balanced vaginal environment and inhibiting pathogenic bacterial growth. ![]() The lactobacilli most frequently found in women are L. Lactobacilli are the most abundant bacteria found in normal vaginal flora. Keywords: Vaginal Lactobacilli Bacteria Introduction The most effective treatment of VL is oral amoxicillin-clavulanate, using doxycycline as an alternative. Lactobacillosis should be differentiated from candidiasis, bacterial vaginosis and cytolytic vaginosis. The etiology is unknown and the prevalence is approximately 15%. It is characterized by the presence of abundant and extremely longer than normal lactobacilli in vaginal wet mount preparations. Vaginal lactobacillosis (VL) is manifested as a very annoying, profuse white vaginal discharge, with the sensation of incessantly having wet the underwear.
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