Resumo

ABADIA-PATINO, Lorena; ROJAS, Luzmarina; SANCHEZ, Elia  e  GUEVARA, Armando. Cytolytic vaginosis: presentation of a clinical case. Rev. Soc. Ven. Microbiol. [online]. 2016, vol.36, n.2, pp.68-70. ISSN 1315-2556.

Cytolytic vaginosis, described 30 years ago as Döderlein cytolysis, is common in women of reproductive age and, due to the characteristics of whitish vaginal discharge and clinical symptoms, is indistinguishable from mycotic vulvovaginitis. We describe the case of a patient with presumptive clinical diagnosis of recurrent vulvovaginitis by Candida spp. treated empirically with antifungal agents for one and a half years without improvement. After microbiological studies, Gram staining demonstrated the presence of 50 Gram-positive bacilli per field and abundant nude cell nuclei. The culture recovered pure Lactobacillus spp. which permitted the diagnosis of cytolytic vaginosis. The patient was treated with ampicillin-sulbactam and since, has not had recurrences. In conclusion, it is essential to examine the pH of the patient vaginal discharge, as well as to practice a Gram staining of the vaginal secretion to demonstrate the cellular changes produced by the excess of acid in the vagina and therefore avoid unnecessary antifungal treatments that will produce undue changes of the vaginal microbiota.

Palavras-chave : Lactobacillus spp; Gram stain; treatment failure; cytolytic vaginosis.

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