DGI:Gynäkologische Infektionen/Diagnostik: Unterschied zwischen den Versionen

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Version vom 22. Dezember 2020, 18:31 Uhr

Diagnostik

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
pH-Wert Messung
Beurteilung eines Nativpräparats des Fluors
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.[3]


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

@@ Zeile 29: / Zeile 29: @@
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 |+
-! 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" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |'''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" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |'''Nugent-Score'''
 |- 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)
@@ Zeile 49: / Zeile 49: @@
 {| 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="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" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |'''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" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |'''Nugent-Score'''
 |- 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)
@@ Zeile 69: / Zeile 69: @@
 {| 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="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" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |'''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" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |'''Nugent-Score'''
 |- 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)
@@ Zeile 102: / Zeile 102: @@
 {| 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;"
 |+
-! 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" width="290" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:217.7pt;&quot;}" |'''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" width="285" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:213.55pt;&quot;}" |'''Diagnostische Schritte'''
 |- 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
-<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
-<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
-<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
+* A-Streptokokken
+| style="width:213.55pt;" width="285" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:213.55pt;&quot;}" |
+* 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
 |- 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: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;" 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> 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;"
 | style="width:217.7pt;" width="290" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:217.7pt;&quot;}" |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;" 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> 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
@@ Zeile 128: / Zeile 129: @@
 <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
 |}
@@ Zeile 136: / Zeile 136: @@
 {| 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="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" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |'''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" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |'''Differentialdiagnose'''
 |- 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:233.65pt;" 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:
-<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;"
 | style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |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;" 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> 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;"
 | style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |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;" 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> 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;"
 | style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |Kolpitis
 | style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |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
 |}