ABSTRACT
This chapter discusses three separate clinical syndromes—cytolytic vaginosis (CTV), aerobic vaginitis (AV), and desquamative inflammatory vaginitis (DIV) —. It describes three clinical entities which frequently lead clinicians astray as their clinical presentations mimic those of the more familiar Candida vaginitis (CV), bacterial vaginosis (BV), and Trichomonas vaginalis vaginitis (TVV). Detection requires that physicians know that these entities exist and are aware that the clinical presentations in these cases diverge from the more frequently encountered vaginal pathophysiology. CTV is a microscopy-based diagnosis in women with vaginal symptoms that resemble vulvovaginal candidiasis. A reevaluation of those patients who remain symptomatic after unsuccessful antifungal treatment is required to confirm the diagnosis of CTV. The vaginal pH is acidic, and on microscopic exam, there are huge numbers of Lactobacilli present, including many long Lactobacilli in the free space between cells, and many are attached to fragmented epithelial cells.
