Vaginal leucocyte counts in women with bacterial vaginosis: relation to vaginal and cervical infections.
OBJECTIVE
To evaluate whether an elevated vaginal leucocyte count in women with bacterial vaginosis (BV) predicts the presence of vaginal or cervical infections, and to assess the relation of vaginal WBC counts to clinical manifestations.


METHODS
We retrospectively analysed the relation of vaginal leucocyte counts to vaginal and cervical infections and to clinical manifestations in non-pregnant women diagnosed with BV at an STD clinic visit.


RESULTS
Of 296 women with BV studied, the median age was 24 years and 81% were African-American. Elevated vaginal leucocyte counts were associated with objective signs of vaginitis and cervicitis and also predicted candidiasis (OR 7.9, 95% CI 2.2 to 28.9), chlamydia (OR 3.1, 95% CI 1.4 to 6.7), gonorrhoea (OR 2.7, 95% CI 1.3 to 5.4), or trichomoniasis (OR 3.4, 95% CI 1.6 to 7.3). In general, as a screening test for vaginal or cervical infections, vaginal leucocyte count had moderate sensitivities and specificities, low positive predictive values, and high negative predictive values.


CONCLUSIONS
An elevated vaginal leucocyte count in women with BV was a strong predictor of vaginal or cervical infections. Vaginal leucocyte quantification may provide an alternative approach to assessing need for empirical therapy for chlamydia and gonorrhoea, particularly in resource-limited high STD risk settings that provide syndromic management.
Department of Medicine, University of Alabama at Birmingham, 35294-0007, USA. wgeisler@uab.edu
W M
WM
Geisler
S
S
Yu
M
M
Venglarik
J R
JR
Schwebke
D000293:Adolescent; D000328:Adult; D005260:Female; D006558:Herpes Genitalis / Q000175:diagnosis; D006801:Humans; D007958:Leukocyte Count; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D002577:Uterine Cervical Diseases / Q000175:diagnosis*; D014621:Vagina; D019522:Vaginal Discharge; D016585:Vaginosis, Bacterial / Q000175:diagnosis*