Microbiology

for
REPRODUCTION
 VAGINAL DISCHARGE

What have you brought back for me from the New World?
Sites for taking specimen for vaginal discharge
Normal Vaginal cells
Clue Cells
Gardnerella vaginalis
Yeast (Direct smear)
Yeast (Gram)
Candidiasis
Candida albicans (85%)
C. stellatoidea, C. tropicalis,
C. krusei, Torulopsis glabrata

Sexually-associated disease

Itchy / thick curdy discharge

Vaginal soreness, vulvar burning,
dyspareunia, dysuria
Candida albicans
Candida albicans (Gram)
Candida albicans (germ tube)
Trichomonas vaginalis
Trichomoniasis
Protozoan : Trichomonas vaginalis

Profuse, offensive,
greenish-yellow,
frothy vaginal
discharge

Vulvar irritation

Some normal /
minimal
symptoms

Strawberry cervix
Diagnostic guidelines
Trichomoniasis Presumptive Definitive diagnosis
diagnosis

Purulent, frothy Ovoid protozoan Culture for

malodorous with jerky motility trichomonads
using
vaginal discharge (sensitivity:60-70%) Feinberg-Whittington
dysuria, vaginal or Trichosel broth
itch media (Baltimore
Biological Lab)
(Most sensitive)

Flagellated
Saline wet mount trichomonad

Giemsa stain
Chlamydial cervicitis
Chlamydia trachomatis
Majority asymptomatic
IP unknown

Mucopurulent discharge
with inflamed cervix

Investigations
1. Antigen detection (DIF)

2. Culture
Endocervical endothelium

*High risk of re-infection

Retest 3-4 months after Rx (no later than 12 months)
Toxoplasma gondii