What misunderstandings should be avoided in the examination of Bartholinitis

Overview of Bartholinitis Bartholinitis is located at the back of the labia majora on both sides, and the gland duct opens on the inner side of the labia minora near the hymen. Due to the characteristics of the anatomical location, when the vulva is contaminated by sexual intercourse, childbirth or other circumstances, pathogens can easily penetrate and cause inflammation. So, what misunderstandings should be avoided when checking for Bartholinitis? Experts say that it should be distinguished from Bartholin's gland cysts.

It is necessary to differentiate it from Bartholin's gland cyst: the common feature is that both of them have a mass in the Bartholin's gland. However, Bartholinitis is accompanied by fever, and the mass is red, painful, and fluctuating. When pressure is applied, pus can be seen overflowing from the gland opening. However, Bartholin's gland cyst has unchanged skin color, cystic mass, no tenderness, no pus overflowing when pressure is applied, and no systemic symptoms such as fever.

The reference diagnostic criteria for Bartholinitis are as follows:

1. A red, swollen, hard lump can be seen at the lower 1/3 of the labia majora on one side, with obvious tenderness or obvious fluctuation.

2. Having systemic symptoms such as fever.

3. Laboratory examination: The total white blood cell count may increase and pathogens may be detected in the secretions of the lesions.

Symptoms of Bartholinitis:

1. Vulvar swelling and pain: The infection is mostly unilateral, with local swelling and pain in the acute phase. If an abscess is formed, the pain will worsen.

2. Fever: Fever is common, but chills are less common.

Signs of Bartholinitis:

1. Vulvar swelling and pain: The infection is mostly unilateral, with local swelling and pain in the acute phase. If an abscess is formed, the pain will worsen.

2. Fever: Fever is common, but chills are less common.

3. Swollen lymph nodes: If the inflammation persists or recurs, there may be swollen inguinal lymph nodes.

Physical examination for Bartholinitis:

Gynecological examination:

A hard lump can be seen at the lower 1/3 of the labia majora on one side, which is obviously painful. When an abscess is formed, the lump may increase to the size of a chicken egg or a goose egg, and may be obviously painful and fluctuate. The surface skin becomes thinner, and may even rupture naturally and ooze out a large amount of pus. Vaginal examination with a speculum is often difficult and can be postponed depending on the condition.

Laboratory diagnosis:

1. Secretion smear and bacterial culture examination: Generally, secretions are taken from the opening of the Bartholin's glands, the urethral orifice, and the paraurethral glands for smear examination to determine the pathogenic bacteria; or bacterial culture and drug sensitivity test can be performed directly.

2. Routine blood test: The total white blood cell count may increase significantly.

Differential diagnosis:

It is mainly differentiated from Bartholin's gland cyst: their common feature is that both have lumps in the Bartholin's glands. However, Bartholinitis is characterized by fever, and examination shows that the lumps are red, with obvious swelling and pain, and fluctuating sensations. When pressure is applied, pus can be seen overflowing from the gland opening, while Bartholin's gland cysts have unchanged skin color, cystic lumps, no tenderness, no pus overflowing when pressure is applied, and no systemic symptoms such as fever.