Transvaginal sonographic findings associated with emphysematous vaginitis at 32 weeks' gestation

Emphysematous vaginitis is a rare, self-limited entity (≈200 reported cases) characterized by multiple, discrete, gas-filled cystic cavities in the vaginal mucosa or ectocervix. Most patients have vaginal discharge, although some have reported being aware of popping sounds associated with rupture of the cysts, which may occur spontaneously or during intercourse. Evidence suggests that emphysematous vaginitis is an unusual manifestation or a common infection in an immunocompromised or pregnant host. Although both Gardnerella vaginalis and Trichomonas have been implicated, no single organism has been identified as the causative agent. We present transvaginal sonographic findings associated with biopsy-proven emphysematous vaginitis in a patient at 32 weeks' gestation.