caa a22 4500 445309032 CHVBK 20180317142622.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s00404-011-1861-6 doi (NATIONALLICENCE)springer-10.1007/s00404-011-1861-6 Group A streptococcal vaginitis: an unrecognized cause of vaginal symptoms in adult women [Elektronische Daten] [Hans Verstraelen, Rita Verhelst, Mario Vaneechoutte, Marleen Temmerman] Purpose: Vaginal infection with group A streptococci (GAS) is an established cause of vaginitis amongst prepubescent girls, but largely unrecognized in adult women and therefore often misdiagnosed as vulvovaginal candidosis. We sought to give an overview of the epidemiology, risk factors, symptoms, signs, and treatment of GAS vaginitis in adult women. Methods: Systematic literature search. Results: We identified nine case reports covering 12 patients with documented GAS vulvovaginitis. GAS vulvovaginitis in adult women is often associated with a predisposing factor: (1) household or personal history of dermal or respiratory infection due to GAS, (2) sexual contact, and (3) lactational or menopausal vaginal atrophy. Symptoms of GAS vulvovaginitis in adult women may include vaginal and/or vulvar pain, dyspareunia, burning sensation or irritation, and pruritus. In most cases, there is also profuse or copious vaginal discharge which may be watery, yellow, or even purulent. Whilst there are neither clinical trials nor treatment guidelines, treatment with oral penicillin or with vaginal clindamycin cream has been reported to result in rapid cure. In breast-feeding and postmenopausal women with vaginal atrophy, additional treatment with local estriol may be necessary to prevent recurrence. Finally, in case of recurrent GAS vulvovaginitis it will be necessary to assess the patients' asymptomatic household members for pharyngeal and anal carriage and to treat them accordingly. Conclusion: Vaginal infection with GAS in adult women is a clearly defined entity and should be considered a diagnosis when more common causes of vaginitis have been ruled out. Springer-Verlag, 2011 Vaginitis nationallicence Streptococcus pyogenes nationallicence Vaginal discharge nationallicence Vaginal flora nationallicence Verstraelen Hans Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, B-9000, Ghent, Belgium aut Verhelst Rita Department of Clinical Chemistry, Microbiology, and Immunology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium aut Vaneechoutte Mario Department of Clinical Chemistry, Microbiology, and Immunology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium aut Temmerman Marleen Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, B-9000, Ghent, Belgium aut Archives of Gynecology and Obstetrics Springer-Verlag 284/1(2011-07-01), 95-98 0932-0067 284:1<95 2011 284 404 https://doi.org/10.1007/s00404-011-1861-6 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-011-1861-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Verstraelen Hans Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, B-9000, Ghent, Belgium aut NATIONALLICENCE 700 1- Verhelst Rita Department of Clinical Chemistry, Microbiology, and Immunology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium aut NATIONALLICENCE 700 1- Vaneechoutte Mario Department of Clinical Chemistry, Microbiology, and Immunology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium aut NATIONALLICENCE 700 1- Temmerman Marleen Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, B-9000, Ghent, Belgium aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 284/1(2011-07-01), 95-98 0932-0067 284:1<95 2011 284 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer