Vulval Infection

Vulval Infection

Folliculitis, furuncles, carbuncles

Bacterial infections of the vulva, excluding those caused by sexually transmitted organisms, can be classified as Pyodermas, which are, subdivided into infections those involvs hair follicles, apocrine glands, the dermis and cellular planes. The most common of these are follicular infections, which can lead to furuncle or carbuncle formation. Folliculitis can be either a superficial or a deep infection of hair follicule it is characterized by a pustule surrounded by an erythematous papule.

A furuncle is an infection of the deep follicle, involving the tissue beyond the follicle, involving the tissue beyond the follicle. This lesion is hard, tender, and erythematous carbuncles are formed when several follicles become infected and intercommunicate with one another.

Cause:-The most common offending organism isstaphylococcus aureus.

If the lesion is single or and a superficial folliculitis, a topical ointment or lotion such as Bactracin or Neosporin G (polymyxin B sulfate, 10,000 units, Neomycin sulfate 5 mg, and gramicidin 0.25 mg)

Deep-seated infections are (eg. Furncles and carbuncles) require the use of hot compresses to facilitate pointing. This may result in spontaneous drainage. If this does not occur incision and the use of systemic antibiotics may be required.

Treatment can be accomplished with orally administered cephalosporins. (eg. Cephalexin 500 mg every 6 hours; cetadroxil 500 mg every 12 hours or cetactor 500mg every 8 hours for 10days).

In those persons with recurrent lesions, the skin should be cleansed with an antiseptic on a regular basis. In addition, the skin surrounding the area where the lesions are recurring should be treated with repeated applications of a topical antibiotic agent. A specimen should be obtained for isolation and identification of the offending organism. 

Vulvovestibulitis

Focal vulvitis, which often attacks the duct opening of the bartholin gland is characterized by persistent volvovaginitis and burning or discomfort, often associated with dyspareunia or pain. On close inspection there is usually inflammation or redness located at the gland orifice.

Common infections occur in vulvar vestibulitis include. Trichomonas, candida, Gardnereua, herpes, and human papilloma virus.

The treatment described for this condition has varied from close follow up to surgical excision of the hymeneal ring and contiguous vestibule mucosa and submccosa abscess.

Incidence

Abscesses of the Bartholin gland duct have been found in women of all ages, although they predominate in the reproductive years.

Clinical features

Abscesses of the bartholin gland duct usually presented with unilateral swelling of the labia and acute pain. The mass is usually tender, red, and warm to the touch and may be accompanied by localized edema in the area(s). It is extremely painful and usually makes intercourse impossible. It becomes fluctant and warm with thinning of the overlying skin.