title: Emphysematous vaginitis.
abstract: BACKGROUND
  Emphysematous vaginitis is a rare condition, characterized by the presence of multiple gas-filled cysts in the vaginal and/or exocervical mucosa. Although its etiology is not completely understood, it is self-limited, with a benign clinical course. Vaginal discharge, sometimes bloody, and pruritus are the most common symptoms. Chronic and acute inflammation can be found, and diseases that impair the immune system and pregnancy have been associated with this condition.
  
  
  METHODS
  A 48-year-old postmenopausal woman, with a history of hysterectomy with several comorbidities, presented with a 4-month history of bloody discharge and vulvar pruritus. Examination showed multiple cystic lesions, 1 to 5 mm, occupying the posterior and right lateral vaginal walls. Speculum examination produced crepitus. Vaginal wet mount was normal, except for diminished lactobacilli; results of Trichomonas vaginalis DNA test and vaginal cultures were negative. Lugol's iodine applied to the vagina was taken up by the intact lesions. Biopsy result showed typical features of emphysematous vaginitis.
  
  
  CONCLUSIONS
  This is an unusual entity, presenting with common gynecological complaints, and both physicians and pathologists should be aware to prevent misdiagnosis and overtreatment.
authors.affiliation: 1Serviço de Ginecologia e Obstetrícia, Centro Hospitalar de São João, Porto, Portugal, and 2Serviço de Anatomia Patológica, Centro Hospitalar de São João, Porto, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Lima-Silva
authors.forename: Pedro
authors.initials: P
authors.lastname: Vieira-Baptista
authors.forename: João
authors.initials: J
authors.lastname: Cavaco-Gomes
authors.forename: Tiago
authors.initials: T
authors.lastname: Maia
authors.forename: Jorge
authors.initials: J
authors.lastname: Beires
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D014621:Vagina / Q000473:pathology*; D019522:Vaginal Discharge / Q000209:etiology*; D014627:Vaginitis / Q000175:diagnosis* / Q000473:pathology*