title: Inflammation on the cervical papanicolaou smear: evidence for infection in asymptomatic women?
abstract: BACKGROUND
  The significance of the possible presence of infection on the Pap smear of asymptomatic women based on cytological criteria is practically unknown.
  
  
  METHODS
  A total of 1117 asymptomatic nonpregnant women had Pap smear tests and vaginal as well as cervical cultures completed (622 with and 495 without inflammation on the Pap smear).
  
  
  RESULTS
  Out of the 622 women with inflammation on Pap test, 251 (40.4%) had negative cultures (normal flora present), while 371 (59.6%) women had positive cultures with different pathogens. In contrast, the group of women without inflammation on Pap test displayed significantly increased percentage of negative cultures (67.1%, P < 0.001) and decreased percentage of positive cultures (32.9%, P < 0.001). Bacterial vaginosis was diagnosed more frequently in both groups and significantly more in the group with inflammation on Pap smear compared to the group without inflammation (P < 0.02).
  
  
  CONCLUSIONS
  A report of inflammatory changes on the cervical Pap smear cannot be used to reliably predict the presence of a genital tract infection, especially in asymptomatic women. Nevertheless, the isolation of different pathogens in about 60% of the women with inflammation on the Pap smear cannot be overlooked and must be regarded with concern.
authors.affiliation: Biopathology Laboratory, University of Athens, Aretaieio University Hospital, 11528 Athens, Greece.
authors.forename: Stavroula
authors.initials: S
authors.lastname: Baka
authors.forename: Ioanna
authors.initials: I
authors.lastname: Tsirmpa
authors.forename: Anthia
authors.initials: A
authors.lastname: Chasiakou
authors.forename: Iliana
authors.initials: I
authors.lastname: Tsouma
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Politi
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Gennimata
authors.forename: Evangelia
authors.initials: E
authors.lastname: Kouskouni
mesh_terms: D000328:Adult; D058345:Asymptomatic Infections; D002584:Cervix Uteri / Q000382:microbiology; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D002575:Uterine Cervicitis / Q000175:diagnosis* / Q000382:microbiology; D014621:Vagina / Q000382:microbiology; D014626:Vaginal Smears; D014627:Vaginitis / Q000175:diagnosis* / Q000382:microbiology; D055815:Young Adult