Infectious Disorders of the Lower Genital Tract

Infectious diseases of the lower female genital tract include a variety of bacterial, viral, fungal, and parasitic infections that are commonly, but not exclusively, sexually transmitted. Sexually transmitted diseases (STDs) are a global public health issue and have serious impact on health care costs in the United States. The Centers for Disease Control and Prevention announced increasing numbers of reported STDs in recent years. Chlamydia, gonorrhea, and especially syphilis rates have increased dramatically over the past few years. Most infections of the lower female genital tract are diagnosed clinically, and tissue biopsies are rarely performed; however, it is important to be familiar with these entities and their histopathologic features to avoid misdiagnosis of these rather common infections. This chapter reviews clinical and pathologic presentations of common infections of the lower female genital tract, and incorporates the latest guidelines available for each entity. Human papillomavirus infection is briefly discussed under common sexually transmitted infections and generalized genital warts in patients with immunosuppression, and further reviewed in detail in other chapters. It also includes rare entities in the United States that should be considered in the differential diagnosis of patients with human immunodeficiency virus infection and vulvovaginal involvement by systemic infections in immunosuppressed individuals.