Cytomorphological spectrum of cervicovaginal infections and their prevalence with clinical correlation on pap smears: A three-year retrospective study

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Cervical-vaginal infections are one of the most common infections seen in women of the reproductive age group. The important infectious agents in Gardnerella vaginalis, Candida, and Trichomonas vaginalis. Pap smear cytology is used as an important screening test for various epithelial cell abnormalities and cervical cancer. It is also useful in the diagnosis of various pathogenic microorganisms causing cervicovaginal infections. To determine the prevalence of cervicovaginal infections on Pap smears, and study their cytomorphology and clinical correlation. : This is a three-year retrospective study from June 2018 to May 2021 performed on conventional Pap smears in the Pathology laboratory of a Government hospital in North India. The prevalence of various cervicovaginal infections was determined and their cytomorphological spectrum was studied. The Bethesda System of classification was followed for reporting Pap smears. All the females attending Gynaecology OPD of the hospital with various complaints were included. Females with a history of cervical cancer and unsatisfactory samples were excluded from the study. Out of the total number1344 pap smears examined during the three years, 1291 (96.058%) were reported as NILM, remaining 53(3.044%) were diagnosed as epithelial cell abnormalities and cervical cancer. Among the 1291 cases of NILM, 421(32.61%) smears were positive for specific pathogenic microorganisms. Out of, 421 smears, examined,254(60.33%) were BV followed by136 (32.30%) of candida infection. Trichomonas contributed to 22(5.22%) cases, whereas in one case (0.23%) each of Actinomyces and HSV was seen. Mixed infection by Trichomonas and leptothrix was seen in 4(0.950%) cases and Candida and leptothrix contributed to 3(0.712%) cases. Cervico-vaginal infections are an important cause of morbidity in the reproductive age group. Cervical cytology is an invaluable method to diagnose these infections. About 90% of infections are caused by Bacterial Vaginosis and Candida. All women of the reproductive age group should undergo a Pap smear examination for timely diagnosis and proper management of cervicovaginal infections.