What are the diagnostic methods for Bartholinitis?

Bartholinitis has a huge impact on women's bodies, so we need to pay attention to proper health care in our daily lives, and detect this disease as early as possible in daily life to avoid more impacts and reasonable treatment. We need to pay attention to the common diagnostic methods of this disease. So, what are the diagnostic methods for Bartholinitis? Let's take a look at the following introduction.

1. Disease Overview

The Bartholin's glands are located at the back of the labia majora on both sides, and the gland ducts open between the hymen and the labia minora. Bartholin's gland inflammation usually occurs in women of childbearing age, and is rare in infants and young children and after menopause.

【Etiology and pathogenesis】

Due to the characteristics of the anatomical part, when the vulva is contaminated by sexual intercourse, childbirth or other circumstances, pathogens can easily invade and cause Bartholinitis. The main pathogens are Staphylococcus, Escherichia coli, Streptococcus, and Enterococcus. With the increase of sexually transmitted diseases, Neisseria gonorrhoeae and Chlamydia trachomatis have become common pathogens. If the opening of the Bartholin's gland duct is blocked, secretions accumulate in the gland cavity, which can form Bartholin's gland cysts, and secondary infection can form Bartholin's gland abscesses.

【Clinical manifestations】

During an acute inflammation attack, one side is usually invaded, first the gland duct, leading to Bartholin's gland ductitis, local skin redness, swelling, and pain. Examination shows small white spots at the opening of the Bartholin's gland on the affected side, which are obviously tender. Blockage of the gland duct opening can form an abscess, which intensifies the pain and causes local fluctuations, called a Bartholin's gland abscess, which may be accompanied by fever and swollen inguinal lymph nodes. When the acute inflammation subsides, the gland duct opening is blocked and a cyst is formed, called a Bartholin's gland cyst. If the cyst is small and not infected, the patient may have no symptoms. If the cyst is large, the patient may feel a swelling in the vulva or discomfort during sexual intercourse. Examination shows that the cyst is mostly unilateral or bilateral. The cyst is oval in shape and varies in size, and may remain unchanged for several years.

Diagnosis and differential diagnosis

Bartholinitis can be preliminarily diagnosed based on medical history and symptoms. If there is a red, swollen, tender mass or a sense of fluctuation in the Bartholin gland area, it can generally be diagnosed as a Bartholin gland cyst or abscess. If necessary, puncture diagnosis can be performed, and pus can be extracted from abscesses and mucus from cysts.

2. Test and Diagnosis

The pathogens of Bartholin's gland inflammation and Bartholin's gland abscess are mainly Staphylococcus, Streptococcus, Escherichia coli, Pseudomonas aeruginosa, Neisseria gonorrhoeae, etc., and are often mixed infections of multiple bacteria. The diagnosis of this disease is mainly based on clinical symptoms, and can be combined with the following laboratory tests when necessary.

【General inspection items】

White blood cell count:

1. Most detection methods use automated hematology analyzers.

2. Specimen: EDTAK2 anticoagulated whole blood.

3Reference range (4.0～10)×109/L.

4 Clinical diagnostic significance and evaluation: An increased white blood cell count is not a specific indicator of Bartholinitis and Bartholin's gland abscess, but the total white blood cell count in such patients may be significantly increased.

【Special inspection items】

1. Microscopic examination of secretions or puncture fluid

(1) Specimen collection: In patients with Bartholinitis, secretions are usually collected from the Bartholin gland opening, urethral orifice, and paraurethral glands. In patients with Bartholin gland abscess or cyst, puncture fluid can be extracted aseptically.

(2) Examination method: Smear the secretions or puncture fluid, and after Gram staining, check for the presence of bacteria under an oil microscope and observe the morphology and staining characteristics of the bacteria.

(3) Clinical diagnostic significance and evaluation:

1) Pus is drawn out from an abscess, while mucus is drawn out from a cyst.

2) After Gram staining of the secretions or pus smear of Bartholin's glanditis, bacteria can usually be found under a microscope, and a preliminary diagnosis of the pathogen can be made based on the bacterial morphology and Gram staining characteristics.

2. Bacterial culture of secretions or puncture fluid

(1) Inspection method:

1) Isolation and culture of common bacteria: Aseptically collect the secretions of Bartholin's gland inflammation or the puncture fluid of Bartholin's gland abscess or cyst, inoculate them on blood agar plates in zones and streak them, place them in an incubator at 35"C for 18-24 hours, and observe the growth of bacteria. If there is only one bacterium, conduct identification test directly. If there are two or more bacteria, separate and purify them, and then conduct systematic biochemical identification to determine the species.

2) Isolation and culture of gonococci: Aseptically collect the secretions of Bartholin's gland inflammation or the puncture fluid of Bartholin's gland abscess or cyst and inoculate it on a gonococcal plate (TM culture medium), place it in an incubator at 35°C with 5% CO2 for 24 to 72 hours, and observe the growth of bacteria. If bacteria grow, determine the species through smear staining microscopy, oxidase test and other biochemical identification.

3) Pathogen drug sensitivity test: Use paper diffusion method or dilution method for detection, judge the results according to CLSI standards, and report the results to the clinic as S, I, and R. Those using the dilution method will also report the MIC value.

(2) Clinical diagnostic significance and evaluation:

1) Pathogens such as Staphylococcus, Streptococcus, Escherichia coli, Pseudomonas aeruginosa, and Neisseria gonorrhoeae can usually be isolated and cultured from specimens of Bartholinitis and Bartholin's abscess.

2) The results of pathogen susceptibility testing can guide the clinical selection of antimicrobial drugs.

【Application suggestions】

1. Because Bartholinitis and Bartholin abscess are often mixed infections of multiple bacteria, in order to accurately and reasonably use antimicrobial drugs, it is a better method to take secretions or puncture fluid for bacterial culture and perform drug sensitivity tests on the isolated pathogens. Smear, staining, and microscopic examination of secretions or puncture fluid can help with the preliminary diagnosis of pathogens.

2. Non-specific peripheral blood leukocyte count can be used as an auxiliary diagnostic indicator for bacterial infection of the Bartholin's glands.

The above is an introduction to the diagnostic methods for Bartholinitis. I hope it will be helpful to you.