DGI:Gynäkologische Infektionen/Diagnostik: Difference between revisions

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==<span class="mw-headline" id="Diagnostik" style="box-sizing: inherit;"><span class="berschrift1Zchn ve-pasteProtect" style="box-sizing: inherit;"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font-size:20.0pt;\nline-height:115%&quot;}" style="box-sizing: inherit; font-size: 20pt; line-height: 30.6667px;">Diagnostik</span></span></span>==


===<span class="mw-headline" id="Diagnosekriterien" style="box-sizing: inherit;">Diagnosekriterien</span>===
===<span class="mw-headline" id="Diagnosekriterien" style="box-sizing: inherit;">Diagnosekriterien</span>===
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===<span class="mw-headline" id="Diagnostische_Schritte" style="box-sizing: inherit;">Diagnostische Schritte</span>===
===<span class="mw-headline" id="Diagnostische_Schritte" style="box-sizing: inherit;">Diagnostische Schritte</span>===
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">a) <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">  <span> </span></span></span>Bakterielle Vaginose
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">a) <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">  <span> </span></span></span>'''<u>Bakterielle Vaginose</u>'''


Die Diagnose der BV wird klinisch gestellt und gilt als gesichert, wenn drei der vier genannten Kriterien positiv sind:
Die Diagnose der BV wird klinisch gestellt und gilt als gesichert, wenn drei der vier genannten Kriterien positiv sind:


Amsel-Kriterien: '''Am'''ingeruch -'''S'''chlüsselzellen, '''e'''rhöhter pH, '''l'''iquider Fluor
{{Hinweis/note|text=Amsel-Kriterien: '''Am'''ingeruch -'''S'''chlüsselzellen, '''e'''rhöhter pH, '''l'''iquider Fluor}}


*Grau-weißer, homogener Fluor
*Grau-weißer, homogener Fluor
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*Ermittlung des Nugent Scores
*Ermittlung des Nugent Scores


Diagnostische Schritte


*Klinische/gynäkologische Untersuchung
'''Diagnostische Schritte'''
*pH-Wert Messung
 
*Beurteilung eines Nativpräparats des Fluors
*Klinische/gynäkologische Untersuchung (im Falle einer Bartholinitis meist ausreichend)
*Klinische/gynäkologische Untersuchung (im Falle einer Bartholinitis meist ausreichend)
*pH-Wert Messung
*pH-Wert Messung
*Beurteilung eines Nativpräparats des Fluors
*Beurteilung eines Nativpräparats des Fluors
*Nugent Score = Erstellung eines gramgefärbten Vaginalabstrichs zur quantitativen und qualitativen Beurteilung der Bakterien Entitäten.[[DGI:Gynäkologische Infektionen#%20ftn3|<span class="MsoFootnoteReference ve-pasteProtect" style="box-sizing: inherit;"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-special-character:footnote&quot;}" style="box-sizing: inherit;"><span class="MsoFootnoteReference ve-pasteProtect" style="box-sizing: inherit;"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font-size:11.0pt;line-height:115%;\nfont-family:\&quot;Arial\&quot;,sans-serif;mso-fareast-font-family:Arial;mso-ansi-language:\nDE;mso-fareast-language:EN-US;mso-bidi-language:AR-SA&quot;}" style="box-sizing: inherit; font-size: 11pt; line-height: 16.8667px; font-family: Arial, sans-serif;">[3]</span></span></span></span>]]
*Nugent Score = Erstellung eines gramgefärbten Vaginalabstrichs zur quantitativen und qualitativen Beurteilung der Bakterien Entitäten.<ref><span style="color: rgb(51, 51, 51)">Nugent, R. P., M. A. Krohn, und S. L. Hillier. „Reliability of Diagnosing Bacterial Vaginosis Is Improved by a Standardized Method of Gram Stain Interpretation“.</span> ''Journal of Clinical Microbiology'' <span style="color: rgb(51, 51, 51)">29, Nr. 2 (Februar 1991): 297–301. <nowiki>https://doi.org/10.1128/JCM.29.2.297-301.1991</nowiki></span><br /></ref>


{| class="wikitable sortable bs-exportable MsoTableGrid" border="1" cellspacing="0" cellpadding="0" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}" style="box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(255, 255, 255); font-size: 14px; color: rgb(51, 51, 51); font-family: &quot;Open Sans&quot;, Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border: none;"
{| class="wikitable sortable bs-exportable MsoTableGrid" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}" style="box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(255, 255, 255); font-size: 14px; color: rgb(51, 51, 51); font-family: &quot;Open Sans&quot;, Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border: none;" cellspacing="0" cellpadding="0" border="1"
|+
|+
! class="col-grey-light-bg" style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |'''Grampositive Stäbchen'''
! style="width:233.6pt;" class="col-grey-light-bg" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |'''Grampositive Stäbchen'''
! class="col-grey-light-bg" style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |'''Nugent-Score'''
! style="width:233.65pt;" class="col-grey-light-bg" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |'''Nugent-Score'''
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |4+ (>30/Gesichtsfeld)
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |4+ (>30/Gesichtsfeld)
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |0
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |0
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |3+ (5-30/Gesichtsfeld)
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |3+ (5-30/Gesichtsfeld)
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |1
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |1
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |2+ (1-4/Gesichtsfeld
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |2+ (1-4/Gesichtsfeld
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |2
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |2
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:4&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:4&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |1+ (<1/Gesichtsfeld)
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |1+ (<1/Gesichtsfeld)
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |3
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |3
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:5;mso-yfti-lastrow:yes&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:5;mso-yfti-lastrow:yes&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |0 (keine in 5 Gesichtsfeldern
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |0 (keine in 5 Gesichtsfeldern
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |4
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |4
|}
|}
{| class="wikitable sortable bs-exportable MsoTableGrid" border="1" cellspacing="0" cellpadding="0" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}" style="box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(255, 255, 255); font-size: 14px; color: rgb(51, 51, 51); font-family: &quot;Open Sans&quot;, Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border: none;"
{| class="wikitable sortable bs-exportable MsoTableGrid" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}" style="box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(255, 255, 255); font-size: 14px; color: rgb(51, 51, 51); font-family: &quot;Open Sans&quot;, Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border: none;" cellspacing="0" cellpadding="0" border="1"
|+
|+
! class="col-grey-light-bg" style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |'''Gramnegative bzw. gramlabile Stäbe (z.B. Gardnerella, Prevotella, Bacteriodes)'''
! style="width:233.6pt;" class="col-grey-light-bg" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |'''Gramnegative bzw. gramlabile Stäbe (z.B. Gardnerella, Prevotella, Bacteriodes)'''
! class="col-grey-light-bg" style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |'''Nugent-Score'''
! style="width:233.65pt;" class="col-grey-light-bg" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |'''Nugent-Score'''
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |4+ (>30/Gesichtsfeld)
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |4+ (>30/Gesichtsfeld)
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |4
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |4
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |3+ (5-30/Gesichtsfeld)
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |3+ (5-30/Gesichtsfeld)
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |3
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |3
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |2+ (1-4/Gesichtsfeld
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |2+ (1-4/Gesichtsfeld
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |2
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |2
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:4&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:4&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |1+ (<1/Gesichtsfeld)
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |1+ (<1/Gesichtsfeld)
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |1
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |1
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:5;mso-yfti-lastrow:yes&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:5;mso-yfti-lastrow:yes&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |0 (keine in 5 Gesichtsfeldern
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |0 (keine in 5 Gesichtsfeldern
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |0
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |0
|}
|}
{| class="wikitable sortable bs-exportable MsoTableGrid" border="1" cellspacing="0" cellpadding="0" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}" style="box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(255, 255, 255); font-size: 14px; color: rgb(51, 51, 51); font-family: &quot;Open Sans&quot;, Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border: none;"
{| class="wikitable sortable bs-exportable MsoTableGrid" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}" style="box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(255, 255, 255); font-size: 14px; color: rgb(51, 51, 51); font-family: &quot;Open Sans&quot;, Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border: none;" cellspacing="0" cellpadding="0" border="1"
|+
|+
! class="col-grey-light-bg" style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |'''Gramlabile gebogene Stäbchen (Mobiluncus)'''
! style="width:233.6pt;" class="col-grey-light-bg" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |'''Gramlabile gebogene Stäbchen (Mobiluncus)'''
! class="col-grey-light-bg" style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |'''Nugent-Score'''
! style="width:233.65pt;" class="col-grey-light-bg" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |'''Nugent-Score'''
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |4+ (>30/Gesichtsfeld)
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |4+ (>30/Gesichtsfeld)
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |2
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |2
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |3+ (5-30/Gesichtsfeld)
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |3+ (5-30/Gesichtsfeld)
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |2
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |2
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |2+ (1-4/Gesichtsfeld
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |2+ (1-4/Gesichtsfeld
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |1
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |1
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:4&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:4&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |1+ (<1/Gesichtsfeld)
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |1+ (<1/Gesichtsfeld)
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |1
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |1
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:5;mso-yfti-lastrow:yes&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:5;mso-yfti-lastrow:yes&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |0 (keine in 5 Gesichtsfeldern
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |0 (keine in 5 Gesichtsfeldern
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |0
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |0
|}
|}
Beurteilung Nugent-Score
 
{| class="wikitable sortable bs-exportable MsoTableGrid" border="1" cellspacing="0" cellpadding="0" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}" style="box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(255, 255, 255); font-size: 14px; color: rgb(51, 51, 51); font-family: &quot;Open Sans&quot;, Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border: none;"
 
 
'''Beurteilung Nugent-Score'''
{| class="wikitable sortable bs-exportable MsoTableGrid" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}" style="box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(255, 255, 255); font-size: 14px; color: rgb(51, 51, 51); font-family: &quot;Open Sans&quot;, Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border: none;" cellspacing="0" cellpadding="0" border="1"
|+
|+
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |Nugent-Score 0 – 3 (negativ)
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |Nugent-Score 0 – 3 (negativ)
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |Kein Anhalt für eine BV
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |Kein Anhalt für eine BV
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |Nugent-Score 4 – 6 (intermediär)
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |Nugent-Score 4 – 6 (intermediär)
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |Ergebnis ist in Zusammenschau mit der klinischen Symptomatik zu beurteilen
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |Ergebnis ist in Zusammenschau mit der klinischen Symptomatik zu beurteilen
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2;mso-yfti-lastrow:yes&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2;mso-yfti-lastrow:yes&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |Nugent-Score 7 – 19 (positiv)
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |Nugent-Score 7 – 19 (positiv)
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |Vom Vorliegen einer BV ist auszugehen
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |Vom Vorliegen einer BV ist auszugehen
|}
|}
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">b) <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;"> </span></span> Weitere Erkrankungen/Infektionen
 
{| class="wikitable sortable bs-exportable MsoTableGrid" border="1" cellspacing="0" cellpadding="0" data-ve-attributes="{&quot;style&quot;:&quot;margin-left:-5.65pt;border-collapse:collapse;border:none;mso-border-alt:&quot;}" style="box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(255, 255, 255); font-size: 14px; color: rgb(51, 51, 51); font-family: &quot;Open Sans&quot;, Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; margin-left: -5.65pt; border: none;"
 
 
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">b) <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;"> </span></span> '''<u>Weitere Erkrankungen/Infektionen</u>'''
{| class="wikitable sortable bs-exportable MsoTableGrid" style="width:100%;" data-ve-attributes="{&quot;style&quot;:&quot;margin-left:-5.65pt;border-collapse:collapse;border:none;mso-border-alt:&quot;}" cellspacing="0" cellpadding="0" border="1"
|+
|+
! class="col-grey-light-bg" style="width:217.7pt;" width="290" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:217.7pt;&quot;}" |'''Erkrankung/Infektion'''
! style="width:217.7pt;" class="col-grey-light-bg" data-ve-attributes="{&quot;style&quot;:&quot;width:217.7pt;&quot;}" width="290" valign="top" |'''Erkrankung/Infektion'''
! class="col-grey-light-bg" style="width:213.55pt;" width="285" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:213.55pt;&quot;}" |'''Diagnostische Schritte'''
! style="width:213.55pt;" class="col-grey-light-bg" data-ve-attributes="{&quot;style&quot;:&quot;width:213.55pt;&quot;}" width="285" valign="top" |'''Diagnostische Schritte'''
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}" style="box-sizing: inherit;"
| style="width:217.7pt;" width="290" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:217.7pt;&quot;}" |Vulvitis
| style="width:217.7pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:217.7pt;&quot;}" width="290" valign="top" |Vulvitis
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> A-Streptokokken
 
| style="width:213.55pt;" width="285" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:213.55pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Kultur aus Fluor
*A-Streptokokken
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font-size:10.0pt;font-family:18thCentury;mso-fareast-font-family:18thCentury;\n mso-bidi-font-family:18thCentury&quot;}" style="box-sizing: inherit; font-size: 10pt;"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">è <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">       </span></span></span> da Resistenzen selten ist eine Testung nicht unbedingt erforderlich
| style="width:213.55pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:213.55pt;&quot;}" width="285" valign="top" |
*Kultur aus Fluor: Da Resistenzen selten, ist eine Testung nicht unbedingt erforderlich


<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Mikroskopie des Fluors: mehr Granulozyten als Epithelzellen, fehlende Laktobazillen, Kettenkokken sind selten, meist nur mehrere hintereinander
*Mikroskopie des Fluors: Mehr Granulozyten als Epithelzellen, fehlende Laktobazillen, Kettenkokken sind selten, meist nur mehrere hintereinander
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}" style="box-sizing: inherit;"
| style="width:217.7pt;" width="290" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:217.7pt;&quot;}" |Erythrasma
| style="width:217.7pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:217.7pt;&quot;}" width="290" valign="top" |Erythrasma
| style="width:213.55pt;" width="285" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:213.55pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Klinische Untersuchung
| style="width:213.55pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:213.55pt;&quot;}" width="285" valign="top" |
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Hautveränderung an typischen Stellen
*Klinische Untersuchung
 
*Hautveränderung an typischen Stellen
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Abstrich und Mikrobiologie meist nicht erforderlich
*Abstrich und Mikrobiologie meist nicht erforderlich
 
*Unter UV-Licht (Wood-Licht) ziegelrote Fluoreszenz
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Unter UV-Licht (Wood-Licht) ziegelrote Fluoreszenz
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3;mso-yfti-lastrow:yes&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3;mso-yfti-lastrow:yes&quot;}" style="box-sizing: inherit;"
| style="width:217.7pt;" width="290" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:217.7pt;&quot;}" |Kolpitis
| style="width:217.7pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:217.7pt;&quot;}" width="290" valign="top" |Kolpitis
| style="width:213.55pt;" width="285" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:213.55pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> gynäkologische Untersuchung
| style="width:213.55pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:213.55pt;&quot;}" width="285" valign="top" |
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Mikroskopie
*Gynäkologische Untersuchung
*Mikroskopie


<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font-family:\&quot;Courier New\&quot;;mso-fareast-font-family:\&quot;Courier New\&quot;&quot;}" style="box-sizing: inherit; font-family: &quot;Courier New&quot;;"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">o <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;"> </span></span></span> Trichomonaden machen ruckartige Bewegung
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font-family:\&quot;Courier New\&quot;;mso-fareast-font-family:\&quot;Courier New\&quot;&quot;}" style="box-sizing: inherit; font-family: &quot;Courier New&quot;;"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">o <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;"> </span></span></span> Trichomonaden machen ruckartige Bewegung
Line 128: Line 132:
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font-family:\&quot;Courier New\&quot;;mso-fareast-font-family:\&quot;Courier New\&quot;&quot;}" style="box-sizing: inherit; font-family: &quot;Courier New&quot;;"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">o <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;"> </span></span></span> Anzahl Granulozyten
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font-family:\&quot;Courier New\&quot;;mso-fareast-font-family:\&quot;Courier New\&quot;&quot;}" style="box-sizing: inherit; font-family: &quot;Courier New&quot;;"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">o <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;"> </span></span></span> Anzahl Granulozyten


<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Abstrich/Kultur
*Abstrich/Kultur
 
*Färbungen nach Giemsa
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Färbungen nach Giemsa
|}<br />
|}
 
===<span class="mw-headline" id="Differentialdiagnosen" style="box-sizing: inherit;">Differentialdiagnosen</span>===
===<span class="mw-headline" id="Differentialdiagnosen" style="box-sizing: inherit;">Differentialdiagnosen</span>===
{| class="wikitable sortable bs-exportable MsoTableGrid" border="1" cellspacing="0" cellpadding="0" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}" style="box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(255, 255, 255); font-size: 14px; color: rgb(51, 51, 51); font-family: &quot;Open Sans&quot;, Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border: none;"
{| class="wikitable sortable bs-exportable MsoTableGrid" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}" style="box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(255, 255, 255); font-size: 14px; color: rgb(51, 51, 51); font-family: &quot;Open Sans&quot;, Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border: none;" cellspacing="0" cellpadding="0" border="1"
|+
|+
! class="col-grey-light-bg" style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |'''Erkrankung/Infektion'''
! style="width:233.6pt;" class="col-grey-light-bg" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |'''Erkrankung/Infektion'''
! class="col-grey-light-bg" style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |'''Differentialdiagnose'''
! style="width:233.65pt;" class="col-grey-light-bg" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |'''Differentialdiagnose'''
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |Vulvitis pustulosa
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |Vulvitis pustulosa
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |Neben Infektionen mit Staph. aureus kommen folgende Erreger/Infektionen in Betracht:
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |Neben Infektionen mit Staph. aureus kommen folgende Erreger/Infektionen in Betracht:
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Candida albicans -> keine Bindung an Follikel
 
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Herpes genitalis: Bläschen und Erosionen


<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Molluscum contagiosa: Virusinfekt
*Candida albicans -> keine Bindung an Follikel
*Herpes genitalis: Bläschen und Erosionen
*Molluscum contagiosa: Virusinfekt
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |Erythrasma
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |Erythrasma
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Fadenpilzinfektion (Tinea inguinalis)
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Ekzem
*Fadenpilzinfektion (Tinea inguinalis)
 
*Ekzem
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Candidose
*Candidose
 
*Psoriasis vulgaris
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Psoriasis vulgaris
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |Bakterielle Vaginose
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |Bakterielle Vaginose
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Chlamydien-Infektion
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Gonorrhoe
*Chlamydien-Infektion
 
*Gonorrhoe
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Mykosen
*Mykosen
 
*<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">Staphylococcus aureus</span>
<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Staphylococcus aureus</span>
*<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">Streptokokken Gruppe A</span>
 
*<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">Trichomonaden</span>
<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Streptokokken Gruppe A</span>
*<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">Vulvitis</span>
 
*<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">Cervixkarzinom</span>
<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Trichomonaden</span>
*<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">Vaginalkarzinom</span>
 
<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Vulvitis</span>
 
<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Cervixkarzinom</span>
 
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> <span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">Vaginalkarzinom</span>
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:4;mso-yfti-lastrow:yes&quot;}" style="box-sizing: inherit;"
|- data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:4;mso-yfti-lastrow:yes&quot;}" style="box-sizing: inherit;"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |Kolpitis
| style="width:233.6pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" width="311" valign="top" |Kolpitis
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |mögliche Ursache:
| style="width:233.65pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" width="312" valign="top" |Mögliche Ursache:
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Pilzinfektion
 
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Viren
 
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Protozoen
 
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Bakterien
 
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Kein Keimnachweis
 
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Gonorrhoe


<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}" style="box-sizing: inherit;">- <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}" style="box-sizing: inherit; font: 7pt &quot;Times New Roman&quot;;">     </span></span> Zervizitis
*Pilzinfektion
*Viren
*Protozoen
*Bakterien
*Kein Keimnachweis
*Gonorrhoe
*Zervizitis
|}
|}

Latest revision as of 21:22, 22 March 2022

Diagnosekriterien

In der Gynäkologie spielt neben der klinisch-gynäkologischen Untersuchung die Mikroskopie von Nativpräparaten eine wichtige Rolle. Darüber hinaus kommt der Mikrobiologie ebenfalls eine entscheidende Rolle zu. Eine umfassende Kenntnis über die verschiedenen Infektionen in der Gynäkologie ist daher unumgänglich.

Diagnostische Schritte

a)    Bakterielle Vaginose

Die Diagnose der BV wird klinisch gestellt und gilt als gesichert, wenn drei der vier genannten Kriterien positiv sind:

  Amsel-Kriterien: Amingeruch -Schlüsselzellen, erhöhter pH, liquider Fluor


  • Grau-weißer, homogener Fluor
  • Nachweis von Schlüssel-Zellen (Clue Cells)
  • Erhöhter vaginaler pH-Wert (> 4,5)
  • Fischartiger Geruch, insbesondere nach Alkalisierung mit 10%iger Kalilauge (KOH)
  • Ermittlung des Nugent Scores


Diagnostische Schritte

  • Klinische/gynäkologische Untersuchung (im Falle einer Bartholinitis meist ausreichend)
  • pH-Wert Messung
  • Beurteilung eines Nativpräparats des Fluors
  • Nugent Score = Erstellung eines gramgefärbten Vaginalabstrichs zur quantitativen und qualitativen Beurteilung der Bakterien Entitäten.[1]
Grampositive Stäbchen Nugent-Score
4+ (>30/Gesichtsfeld) 0
3+ (5-30/Gesichtsfeld) 1
2+ (1-4/Gesichtsfeld 2
1+ (<1/Gesichtsfeld) 3
0 (keine in 5 Gesichtsfeldern 4
Gramnegative bzw. gramlabile Stäbe (z.B. Gardnerella, Prevotella, Bacteriodes) Nugent-Score
4+ (>30/Gesichtsfeld) 4
3+ (5-30/Gesichtsfeld) 3
2+ (1-4/Gesichtsfeld 2
1+ (<1/Gesichtsfeld) 1
0 (keine in 5 Gesichtsfeldern 0
Gramlabile gebogene Stäbchen (Mobiluncus) Nugent-Score
4+ (>30/Gesichtsfeld) 2
3+ (5-30/Gesichtsfeld) 2
2+ (1-4/Gesichtsfeld 1
1+ (<1/Gesichtsfeld) 1
0 (keine in 5 Gesichtsfeldern 0


Beurteilung Nugent-Score

Nugent-Score 0 – 3 (negativ) Kein Anhalt für eine BV
Nugent-Score 4 – 6 (intermediär) Ergebnis ist in Zusammenschau mit der klinischen Symptomatik zu beurteilen
Nugent-Score 7 – 19 (positiv) Vom Vorliegen einer BV ist auszugehen


b)   Weitere Erkrankungen/Infektionen

Erkrankung/Infektion Diagnostische Schritte
Vulvitis
  • A-Streptokokken
  • Kultur aus Fluor: Da Resistenzen selten, ist eine Testung nicht unbedingt erforderlich
  • Mikroskopie des Fluors: Mehr Granulozyten als Epithelzellen, fehlende Laktobazillen, Kettenkokken sind selten, meist nur mehrere hintereinander
Erythrasma
  • Klinische Untersuchung
  • Hautveränderung an typischen Stellen
  • Abstrich und Mikrobiologie meist nicht erforderlich
  • Unter UV-Licht (Wood-Licht) ziegelrote Fluoreszenz
Kolpitis
  • Gynäkologische Untersuchung
  • Mikroskopie

o   Trichomonaden machen ruckartige Bewegung

o   Anzahl Granulozyten

  • Abstrich/Kultur
  • Färbungen nach Giemsa


Differentialdiagnosen

Erkrankung/Infektion Differentialdiagnose
Vulvitis pustulosa Neben Infektionen mit Staph. aureus kommen folgende Erreger/Infektionen in Betracht:
  • Candida albicans -> keine Bindung an Follikel
  • Herpes genitalis: Bläschen und Erosionen
  • Molluscum contagiosa: Virusinfekt
Erythrasma
  • Fadenpilzinfektion (Tinea inguinalis)
  • Ekzem
  • Candidose
  • Psoriasis vulgaris
Bakterielle Vaginose
  • Chlamydien-Infektion
  • Gonorrhoe
  • Mykosen
  • Staphylococcus aureus
  • Streptokokken Gruppe A
  • Trichomonaden
  • Vulvitis
  • Cervixkarzinom
  • Vaginalkarzinom
Kolpitis Mögliche Ursache:
  • Pilzinfektion
  • Viren
  • Protozoen
  • Bakterien
  • Kein Keimnachweis
  • Gonorrhoe
  • Zervizitis
  1. ↑ Nugent, R. P., M. A. Krohn, und S. L. Hillier. „Reliability of Diagnosing Bacterial Vaginosis Is Improved by a Standardized Method of Gram Stain Interpretation“. Journal of Clinical Microbiology 29, Nr. 2 (Februar 1991): 297–301. https://doi.org/10.1128/JCM.29.2.297-301.1991
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