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Incidental vaginal aerobes and anaerobes, streptococci, staphylococci, enterococci, and Escherichia coli. Much more important are Chlamydia trachomatis, Ureaplasma urealyticum, T. vaginalis, Candida spp., Neisseria gonorrhoeae, herpes simplex II (genitalis), and one or more types of HPV.

Acute or chronic. Excluding gonococcal infection, which causes a specific form of acute disease, the relatively uncommon acute nonspecific form is limited to postpartum women and is usually caused by staphylococci or streptococci

Eventually, columnar epithelium undergoes squamous metaplasia or transformation into a stratified squamous epithelium
When the lesion is severe, inflammatory changes can make differentiation from carcinoma difficult on cytologic preparations and even with colposcopy.

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