Abstract
Abstract Background: Vaginal discharge is one of the most common complaint of patients presenting in Gynecology OPD and clinical diagnosis remains subjective, hence the present study was conducted to compare clinical diagnosis with simple side lab tests with swabs sent to microbiology laboratory for further evaluation and results compared to evaluate whether diagnosis can be improved. Material and methods: Vaginal swabs were collected from 100 sexually active patients presenting with vaginal discharge for Wet mount (direct microscopy and KOH mount), pH test and Whiff test (labeled as side lab test for presumptive diagnosis) and for relevant cultures in laboratory of microbiology Department. Results: The study revealed poor correlation (19%) between clinical diagnosis and final laboratory diagnosis (kappa coefficient 0.1982). This may effect treatment provided only on the basis of clinical (visual) examination. However, very encouraging correlation (71%) was observed between presumptive and final lab diagnosis (kappa coefficient= 0.7149) The diagnostic accuracy of these side lab tests for physiological discharge, bacterial vaginosis, candidiasis, mixed vaginitis, trichomoniasis was 84%, 88%, 95.1%, 89% and 98%, respectively, in reference to final lab tests. Conclusion: Simple side lab tests improve diagnosis of vaginitis and should be incorporated in all teaching and tertiary care centers for better management of vaginitis.
Highlights
Vaginal discharge is the most common complaint in the reproductive age group [1]
Patient underwent a per speculum examination during which vaginal swabs were collected and the following side laboratory tests were done for presumptive diagnosis: 1) Wet mount: Wet mount was prepared for direct microscopy for Trichomonas vaginalis, clue cells for bacterial vaginosis and fungal elements for Candida albicans
On correlating clinical diagnosis with the final laboratory diagnosis candidiasis and mixed vaginitis were detected to be over diagnosed while Bacterial Vaginosis and physiological discharge were underdiagnosed on clinical basis
Summary
Vaginal discharge is the most common complaint in the reproductive age group [1]. Vaginal discharge is one of the most common complaint of patients presenting in Gynecology OPD and clinical diagnosis remains subjective, the present study was conducted to compare clinical diagnosis with simple side lab tests with swabs sent to microbiology laboratory for further evaluation and results compared to evaluate whether diagnosis can be improved. Results: The study revealed poor correlation (19%) between clinical diagnosis and final laboratory diagnosis (kappa coefficient 0.1982). This may effect treatment provided only on the basis of clinical (visual) examination. Conclusion: Simple side lab tests improve diagnosis of vaginitis and should be incorporated in all teaching and tertiary care centers for better management of vaginitis
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