The occurrence of Bartholinitis is often related to some pathogens. Common staphylococcal, Escherichia coli and streptococcal infections may cause this disease, so we should focus on prevention from these causes. When we find local redness, swelling, heat and pain, or swelling and burning sensation of the vulva, we should also be vigilant. 1. Cause The pathogens are mostly Staphylococci, Escherichia coli, Streptococci and Enterococci. With the increase in the incidence of sexually transmitted diseases, Neisseria gonorrhoeae and Chlamydia trachomatis have become the most common pathogens. In addition, there are anaerobic bacteria, among which Bacteroides are the most common, because Bacteroides are normal vaginal residents and have a higher chance of infection. This disease is often a mixed infection and often occurs during the reproductive period. 2. Clinical manifestations Acute Bartholin's glanditis is more common on one side. When the disease occurs, the gland duct is first invaded, presenting with acute suppurative inflammatory changes, with local redness, swelling, heat, and pain. That is, the vulva on the affected side is swollen, with a burning sensation, severe pain, and sometimes a feeling of heaviness and difficulty urinating and defecating. The opening of the gland duct is often blocked due to swelling or coagulation of exudate, and the pus cannot flow out, forming an abscess, which is called Bartholin's gland abscess. If an abscess has formed, the lump may feel fluctuating and painful when touched. If not treated in time, the pressure in the abscess cavity may increase and the abscess may rupture on its own. After the pus flows out, the patient feels relieved; if the wound is small and the drainage is not smooth, the disease may recur, often making the patient restless when walking or lying down. Bartholinitis often presents with systemic symptoms such as swollen inguinal lymph nodes, fever, and increased white blood cell count. 3. Diagnosis The diagnosis is not difficult based on medical history and clinical findings. There is a red, swollen, tender lump in the Bartholin's gland area on one side of the vaginal opening of the vulva, which may or may not be adhered to the vulvar skin; if there is a rupture, secretions or pus can be seen flowing out by squeezing the local area; if it is Neisseria gonorrhoeae, the pus is thin and light yellow. When an abscess is formed, the mass will feel fluctuating when touched and may reach a diameter of 5 to 6 cm. The patient may experience enlarged inguinal lymph nodes, fever, and increased white blood cell count. |
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