Vaginal wet mount of candidal vulvovaginitis

A vaginal wet mount (or vaginal smearWebMD - Vaginal Wet Mount
Last Updated: July 15, 2008 or wet prep) is a gynecologic test wherein a sample of

vaginal discharge Vaginal discharge is a mixture of liquid, cells, and bacteria that lubricate and protect the vagina. This mixture is constantly produced by the cells of the vagina and cervix, and it exits the body through the vaginal opening. The composition, amou ...

is observed by

wet mount A microscope slide is a thin flat piece of glass, typically 75 by 26 mm (3 by 1 inches) and about 1 mm thick, used to hold objects for examination under a microscope. Typically the object is mounted (secured) on the slide, and then b ...

microscopy by placing the specimen on a glass slide and mixing with a salt solution. It is used to find the cause of

vaginitis Vaginitis, also known as vulvovaginitis, is inflammation of the vagina and vulva. Symptoms may include itching, burning, pain, discharge, and a bad smell. Certain types of vaginitis may result in complications during pregnancy. The three main ...

and vulvitis.

Applications

Vaginal wet mounts are used in case of vaginitis symptoms such as vaginal itching, burning, rash, odor, or discharge. It may assist in suspicion of

vaginal yeast infection Vaginal yeast infection, also known as candidal vulvovaginitis and vaginal thrush, is excessive growth of yeast in the vagina that results in irritation. The most common symptom is vaginal itching, which may be severe. Other symptoms include burn ...

trichomoniasis Trichomoniasis (trich) is an infectious disease caused by the parasite ''Trichomonas vaginalis''. About 70% of affected people do not have symptoms when infected. When symptoms occur, they typically begin 5 to 28 days after exposure. Symptoms ca ...

and

bacterial vaginosis Bacterial vaginosis (BV) is a disease of the vagina caused by excessive growth of bacteria. Common symptoms include increased vaginal discharge that often smells like fish. The discharge is usually white or gray in color. Burning with urination ...

. Infections such as

chlamydia Chlamydia, or more specifically a chlamydia infection, is a sexually transmitted infection caused by the bacterium '' Chlamydia trachomatis''. Most people who are infected have no symptoms. When symptoms do appear they may occur only several we ...

genital warts Genital warts are a sexually transmitted infection caused by certain types of human papillomavirus (HPV). They are generally pink in color and project out from the surface of the skin. Usually they cause few symptoms, but can occasionally be pai ...

, syphilis,

herpes simplex Herpes simplex is a viral infection caused by the herpes simplex virus. Infections are categorized based on the part of the body infected. Oral herpes involves the face or mouth. It may result in small blisters in groups often called col ...

, and

gonorrhea Gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium ''Neisseria gonorrhoeae''. Infection may involve the genitals, mouth, or rectum. Infected men may experience pain or burning with u ...

can also affect the vagina, but these diseases are found by doing other tests. It may also be used in a

rape investigation Rape investigation is the procedure to gather facts about a suspected rape, including forensic identification of a perpetrator, type of rape and other details. The vast majority of rapes are committed by persons known to the victim: only betw ...

to detect presence of

semen Semen, also known as seminal fluid, is an organic bodily fluid created to contain spermatozoa. It is secreted by the gonads (sexual glands) and other sexual organs of male or hermaphroditic animals and can fertilize the female ovum. Sem ...

Method

Vaginal wet mounts are not done during the menstrual period, because menstrual blood on the slide can confound the results. Vaginal irrigation, tampon use or sex (potentially disrupting the vaginal pH) should be avoided for 24 hours before the test. Vaginal medicines (such as a nonprescription vaginal yeast medicine) should not be used during the 2 to 3 days before the test. The sampling is done with the patient in

lithotomy position The lithotomy position is a common position for surgical procedures and medical examinations involving the pelvis and lower abdomen, as well as a common position for childbirth in Western nations. The lithotomy position involves the positioning of ...

. A speculum is used to facilitate use of a swab or spatula to sample fluid inside the vagina. The sampling procedure may cause some discomfort and minor bleeding, but otherwise there are no associated risks. The sample is then smeared upon a

microscope slide A microscope slide is a thin flat piece of glass, typically 75 by 26 mm (3 by 1 inches) and about 1 mm thick, used to hold objects for examination under a microscope. Typically the object is mounted (secured) on the slide, and then b ...

and is observed by

microscopy by placing the specimen on a glass slide and mixing with a salt solution.

Interpretation

Normally, no yeast or trichomonas are found on the slide. White blood cells and

clue cell Clue cells are epithelial cells of the vagina that get their distinctive stippled appearance by being covered with bacteria. The etymology behind the term "clue" cell derives from the original research article from Gardner and Dukes describing the ...

s are normally absent or very low in number. Symptoms of infections able to be diagnosed by wet mount: * A vaginal

yeast infection Candidiasis is a fungal infection due to any type of '' Candida'' (a type of yeast). When it affects the mouth, in some countries it is commonly called thrush. Signs and symptoms include white patches on the tongue or other areas of the mouth ...

often causes a white, lumpy discharge that looks like cottage cheese. :*diagnosis is made if pseudohyphae or yeast buds are present (these are visible only 50% of the time) *

Trichomoniasis Trichomoniasis (trich) is an infectious disease caused by the parasite ''Trichomonas vaginalis''. About 70% of affected people do not have symptoms when infected. When symptoms occur, they typically begin 5 to 28 days after exposure. Symptoms ca ...

causes a vaginal discharge that is yellow-green, foamy, and bad-smelling. :*Diagnosis is made if mobile trichomonads are visible on the slide Vaginal wet mount with clue cell - annotated

Vaginal wet mount with clue cell - annotated

Bacterial vaginosis Bacterial vaginosis (BV) is a disease of the vagina caused by excessive growth of bacteria. Common symptoms include increased vaginal discharge that often smells like fish. The discharge is usually white or gray in color. Burning with urination ...

generally produces a vaginal discharge that is thin and milky with a fishy odor. :*Diagnosis is made using Amsel Criteria - three of the four following criteria must be met: ::*>20% of the epithelial cells are clue cells (the single most reliable predictor) ::*Discharge is thin and homogeneous ::*Sample smells fishy when mixed with potassium hydroxide ("whiff test") ::*Vaginal pH is >4.5 Furthermore, presence of

white blood cells White blood cells, also called leukocytes or leucocytes, are the cells of the immune system that are involved in protecting the body against both infectious disease and foreign invaders. All white blood cells are produced and derived from mult ...

is a general sign of infection.

Concomitant vaginal discharge tests

A vaginal discharge sample wet mount is often also used for the following additional tests: * KOH slide. A sample of the vaginal discharge is placed on a slide and mixed with a solution of

potassium hydroxide Potassium hydroxide is an inorganic compound with the formula K OH, and is commonly called caustic potash. Along with sodium hydroxide (NaOH), KOH is a prototypical strong base. It has many industrial and niche applications, most of which exp ...

(KOH). The KOH kills bacteria and cells from the vagina, leaving only yeast for easier detection of a yeast infection. Several drops of a potassium hydroxide (KOH) solution may also be added to a sample of the vaginal discharge to test for any resultant strong fishy odor from the mix, which would indicate bacterial vaginosis. The latter procedure is called a ''Whiff test''. * Vaginal pH test. The normal vaginal pH is 3.8 to 4.5. Bacterial vaginosis, trichomoniasis, and atrophic vaginitis often cause a vaginal pH higher than 4.5. If indicated, the sample can also be used for: * Detecting

atrophic vaginitis Atrophic vaginitis is inflammation of the vagina as a result of tissue thinning due to not enough estrogen. Symptoms may include pain with sex, vaginal itchiness or dryness, and an urge to urinate or burning with urination. It generally does ...

by additional staining. * Vaginal culture, to see if bacteria, yeast, or trichomonads will grow.

References

{{DEFAULTSORT:Vaginal Wet Mount Female genital procedures

Applications

Method

Interpretation

Concomitant vaginal discharge tests

See also

References