II. Labs: Microscopy

  1. See Vaginal pH
  2. See Cervicitis
  3. See Sexually Transmitted Infection for complete genitourinary testing
  4. Patient collected samples
    1. Patient collected samples appear to be as accurate as those collected by clinicians
    2. Instruct patients to insert swab at least one inch into vagina
    3. Strauss (2005) Infect Dis Obstet Gynecol 13(1): 31-5 [PubMed]
  5. Normal
    1. Few Polymorphonuclear Leukocytes (PMNs)
    2. Vaginal epithelial cells
  6. KOH Preparation: Pseudo-hyphae or budding yeast
    1. Candida Vulvovaginitis
  7. Saline preparation (Wet Prep)
    1. Pear-shaped motile organisms: TrichomonasVaginitis
      1. Replaced with DNA Probe (see below)
      2. Poor Test Sensitivity: 50-65%
      3. Sample must be viewed soon after collection (Trichomonas loses motility with delay)
    2. Clue Cells: Bacterial Vaginosis
    3. Numerous Leukocytes
      1. TrichomonasVaginitis
      2. Gonorrhea
      3. Chlamydia
    4. Desquamative Vaginitis (local irritant induced)
      1. Many White Blood Cells
      2. Parabasilar cells

III. Labs: Newer advanced screening

  1. DNA probe for Trichomonas
    1. Preferred over microscopy in symptomatic or high risk women
    2. Nucleic Acid Amplification Test (NAAT) Sensitivity: >95%
    3. Rapid swabs are also available, with Test Sensitivity 80-90%
  2. Multiple DNA Probe Test (e.g. BD Affirm VPIII Microbial Identification Test)
    1. High Sensitivity for Bacterial Vaginosis, Trichomoniasis, and Vulvovaginal Candidiasis
    2. Some False Positives with Trichomoniasis
    3. Requires 45 minutes to run
  3. Sialidase Activity
    1. Specific for gardnerella vaginalis

IV. References

  1. McCollum in Swadron (2022) EM:Rap 22(10): 16-8

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Related Studies

Ontology: Microscopic observation:Prid:Pt:Vag:Nom:KOH preparation (C0797536)

Concepts Clinical Attribute (T201)
LNC 14356-0
English Microscopic observation:Prid:Pt:Vag:Nom:KOH preparation, Microscopic observation [Identifier] in Vaginal fluid by KOH preparation, KOH Prep Vag, Microscopic observation:Presence or Identity:Point in time:Vagina:Nominal:KOH preparation

Ontology: Wet preparation (C1442048)

Concepts Laboratory Procedure (T059)
LNC LP6760-5
English Wet preparation