Vaginitis - Diagnosis

Vaginitis - Diagnosis

Clinical diagnosis is based on the symptoms and a pelvic examination


During the pelvic exam a speculum is introduced into the vagina for direct visualization of the cervix. The following features are noted:

• The amount, nature, color and odor of the discharge is noted.
• The vaginal mucosa is observed for any bleeding, atrophy and reddening,
• Yeast infection reveals thrush-like patches and scratch marks on the mucous membrane of the vagina
• In trichomoniasis a thin, greenish yellow, bubbly discharge is seen and the mucous membrane has a reddened strawberry-like appearance.

The discharge is collected and the following tests are done to aid in the diagnosis.

Saline wet - mount preparation

A wet preparation of the discharge is made on glass slide and observed under a microscope to make the following evaluations:

• Presence of budding yeasts or pseudo hyphae is suggestive of Yeast Infection.
• Presence of clue cells is suggestive of bacterial vaginosis
• Presence of trichomonads is suggestive of trichomoniasis.

Potassium hydroxide (KOH) preparation - The vaginal discharge is mixed with a solution of potassium hydroxide (KOH). The presence of yeast hyphae and spores indicate a yeast infection.

Vaginal pH - The normal vaginal pH is 3.8 to 4.5. pH more than 4.5 is suggestive of Bacterial Vaginosis (BV), trichomoniasis, or atrophic vaginitis.

Whiff test - The vaginal discharge is mixed with potassium hydroxide (KOH) solution and the odor observed. A b fishy odor is suggestive of Bacterial Vaginosis (BV).

Vaginitis - References

1. Vaginitis - (http://www.mayoclinic.com/health/vaginitis/DS00255)
2. About Vaginitis - (http://www.emedicine.com/emerg/topic631.htm)

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