title: Is vaginal microscopy an essential tool for the management of women presenting with vaginal discharge?
abstract: Point-of-care microscopy is the gold standard for the diagnosis of vaginal discharge in genitourinary (GU) medicine clinics but not used in primary care settings and reproductive health clinics to which many patients present. In our GU medicine clinic setting, we conducted an audit to assess the utility of microscopy of vaginal secretions versus clinical diagnosis alone for the differential diagnosis of uncomplicated lower vaginal infections. Clinical diagnosis (including pH) of bacterial vaginosis had a sensitivity between 85% and 88% at two clinic sites. Our results suggest that it may be safe and more cost-effective to restrict vaginal microscopy to a subgroup of women presenting with vaginal discharge.
authors.affiliation: Department of Genito-Urinary Medicine, The Mortimer Market Centre, Camden PCT, London, UK. monix@doctors.net.uk
authors.forename: R M
authors.initials: RM
authors.lastname: Lascar
authors.forename: H
authors.initials: H
authors.lastname: Devakumar
authors.forename: E
authors.initials: E
authors.lastname: Jungmann
authors.forename: A
authors.initials: A
authors.lastname: Copas
authors.forename: G
authors.initials: G
authors.lastname: Arthur
authors.forename: D
authors.initials: D
authors.lastname: Mercey
mesh_terms: D000554:Ambulatory Care Facilities; D002175:Candida / Q000302:isolation & purification; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008131:London; D008485:Medical Audit; D008853:Microscopy / Q000379:methods*; D019095:Point-of-Care Systems; D015995:Prevalence; D012680:Sensitivity and Specificity; D014621:Vagina / Q000382:microbiology*; D019522:Vaginal Discharge / Q000175:diagnosis* / Q000382:microbiology; D014623:Vaginal Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000469:parasitology; D014626:Vaginal Smears; D016585:Vaginosis, Bacterial / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology