Does the presence of vaginitis on a Pap smear correlate with clinical symptoms in the patient?
OBJECTIVE
To investigate the association of the finding of trichomoniasis, candidiasis or bacterial vaginosis (BV) on Pap smear with possible symptoms, findings on the clinical examination or treatment that the patient received shortly before or shortly after the results of the Pap smear.


METHODS
Cases were selected from the Department of Pathology, UMDNJ-University Hospital, Newark. Retrospective chart review of patients who had a diagnosis of Trichomonas or Candida infection or bacterial vaginosis on Pap smear was performed. Controls were patients with none of these organisms on Pap smear.


RESULTS
We reviewed 761 charts. Of the patients represented, 78 were menopausal, 258 were pregnant and 425 were neither menopausal nor pregnant; 533 (70%) of the patients had an organism associated with vaginitis on their Pap smear. There was a significant association (p <0.001) between a positive Pap smear finding and signs, symptoms or treatment for vaginitis overall. By individual organism, there was a significant association between a positive Pap smear and clinical indicators of Candida and Trichomonas, but not of BV.


CONCLUSIONS
Finding Candida or Trichomonas organisms on a Pap smear is a reliable indicator of vaginitis associated with these organisms. Finding organisms consistent with a shift in vaginal flora (BV) on Pap smear did not correlate with clinical indicators of vaginitis.
Heller
Debra S
DS
Department of Pathology, UMDNJ-New Jersey Medical School, Newark, NJ 07101, USA. hellerds@umdnj.edu
Pitsos
Miltiadis
M
Skurnick
Joan
J
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000209:etiology; D011537:Pruritus / Q000209:etiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D019522:Vaginal Discharge / Q000209:etiology; D014626:Vaginal Smears; D014627:Vaginitis / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology