The laboratory investigation of vaginal discharge

Epidemiology and clinico-investigative study of organisms causing vaginal discharge

BACKGROUND

Abnormal vaginal discharge is a common clinical problem in reproductive age group. It is the second most common problem after abnormal uterine bleeding. It is a neglected health problem, most commonly caused due to vulvovaginal candidiasis, trichomoniasis, and bacterial vaginosis (BV).

OBJECTIVES

The present study was conducted to determine the prevalence of common organisms causing vaginal discharge and also to know the variety of clinical presentation.

MATERIALS AND METHODS

A cross-sectional descriptive study was conducted in the Skin and STD Outpatient Department of Vinayaka Mission Kirupananda Variyar Medical College Hospital, Salem, who presented with abnormal vaginal discharge between September 2012 and September 2014. A total of 100 women in the reproductive age group who had symptoms of vaginitis were examined. Data were coded and analyzed.

RESULTS

Out of the 100 patients examined, 77 (77%) cases were organism positive. Among the positive cases, BV (27%) was the most common microbiological cause of abnormal vaginal discharge, followed by trichomoniasis (25%), vaginal candidiasis (22%), combined infection (Candida and BV) (3%), and nonspecific cases (23%).

CONCLUSION

Out of 100 cases, few cases showed discordance between clinical and laboratory diagnosis. This discordance can be due to pitfalls in identifying the causative agent clinically or obscuring of the findings due to improper treatment received for other ailments. Thus, clinico-investigative correlation is more important than other clinical findings alone.

Epidemiology and clinico-investigative study of organisms causing vaginal discharge

BACKGROUND

Abnormal vaginal discharge is a common clinical problem in reproductive age group. It is the second most common problem after abnormal uterine bleeding. It is a neglected health problem, most commonly caused due to vulvovaginal candidiasis, trichomoniasis, and bacterial vaginosis (BV).

OBJECTIVES

The present study was conducted to determine the prevalence of common organisms causing vaginal discharge and also to know the variety of clinical presentation.

MATERIALS AND METHODS

A cross-sectional descriptive study was conducted in the Skin and STD Outpatient Department of Vinayaka Mission Kirupananda Variyar Medical College Hospital, Salem, who presented with abnormal vaginal discharge between September 2012 and September 2014. A total of 100 women in the reproductive age group who had symptoms of vaginitis were examined. Data were coded and analyzed.

RESULTS

Out of the 100 patients examined, 77 (77%) cases were organism positive. Among the positive cases, BV (27%) was the most common microbiological cause of abnormal vaginal discharge, followed by trichomoniasis (25%), vaginal candidiasis (22%), combined infection (Candida and BV) (3%), and nonspecific cases (23%).

CONCLUSION

Out of 100 cases, few cases showed discordance between clinical and laboratory diagnosis. This discordance can be due to pitfalls in identifying the causative agent clinically or obscuring of the findings due to improper treatment received for other ailments. Thus, clinico-investigative correlation is more important than other clinical findings alone.

Analysis of risk factors and clinical and laboratory characteristics of inflammatory diseases of the urogenital tract in women of reproductive age

The article presents an analysis of clinical and medical history data of female patients suffering from inflammatory diseases of the lower urogenital tract caused by opportunistic microorganisms. The authors analyzed the results of the bacterioscopic and bacteriological examinations obtained from the patients. They present data on clinically significant associations of microorganisms. The authors studied the dependence of clinical characteristics of the course of the inflammatory process on the nature of associations of inflammatory agents, and presented the results of their study.

The aetiology of bacterial vaginosis

Bacterial vaginosis (BV) is the most common vaginal infection among women of childbearing age. This condition is notorious for causing severe complications related to the reproductive health of women. Five decades of intense research established many risk factors for acquisition of BV; however, because of the complexity of BV and lack of a reliable animal model for this condition, its exact aetiology remains elusive. In this manuscript, we use a historical perspective to critically review the development of major theories on the aetiology of BV, ultimately implicating BV-related pathogens, healthy vaginal microbiota, bacteriophages and the immune response of the host. None of these theories on their own can reliably explain the epidemiological data. Instead, BV is caused by a complex interaction of multiple factors, which include the numerous components of the vaginal microbial ecosystem and their human host. Many of these factors are yet to be characterized because a clear understanding of their relative contribution to the aetiology of BV is pivotal to the formulation of an effective treatment for and prophylaxis of this condition.

Clinical and microbiological features of Haemophilus influenzae vulvovaginitis in young girls

AIMS

To define the clinical and microbiological features of vulvovaginitis in prepubertal girls whose genital swabs yielded Haemophilus influenzae.

METHODS

Laboratory based study and retrospective collection of clinical data from the requesting doctors.

RESULTS

Thirty eight isolates of non-capsulate Haemophilus influenzae and one of H parainfluenzae were isolated from 32 girls aged 18 months to 11 years. No other pathogens, such as beta haemolytic streptococci or yeasts, were present with H influenzae. The most common biotype was biotype II, comprising 57% of the 26 isolates biotyped. Six children had more than one episode of vulvovaginitis caused by H influenzae and a total of 14 children had recurrent vaginal symptoms.

CONCLUSION

Children who have H influenzae vulvovaginitis are at risk of recurrent symptoms. Biotype II is the one most commonly associated with this condition.

Variation in feminine hygiene practices as a function of age

OBJECTIVE

To examine variation in feminine hygiene practices as a function of increasing age.

DESIGN

A nonexperimental, descriptive research design with study sample stratified by age.

PARTICIPANTS

Women over 18 years of age. Of 713 women who completed and returned the feminine hygiene practices questionnaire, 180 were younger than 41 years, 171 were 41-48 years, 184 were 49-57 years, and 178 were 58 years or older. All participants were members of a California professional home economics organization.

MAIN OUTCOME MEASURES

A 40-item feminine hygiene practices questionnaire dealing with body cleansing practices, feminine products usage, and both general and specific menses collection and protection practices.

RESULTS

Significant age-related differences were found in several areas of body cleansing and feminine products usage, including sponge bathing and use of feminine and deodorant spray, wet wipes, and panty liners. In all age groups, 20-30% of women reported douching, even in the face of continued reports of the dangers in this practice. In addition, reduced numbers of women (n = 245) in all age groups reported washing hands before using tampons or pads, although more (n = 314) reported washing their hands afterward.

CONCLUSIONS

Continuing education about proper feminine hygiene practices, especially regarding douching and handwashing before and after genitourinary contact, will be important across all age groups.

Colonisation of point of use water filters by silver resistant non-tuberculous mycobacteria

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Laboratory diagnosis of vaginal discharge (ACP Broadsheet No 153)

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