International Journal of STD & AIDS > Volume 19, Number 12 > Pp. 859-860

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Audit reports

Is vaginal microscopy an essential tool for the management of women presenting with vaginal discharge?

R M Lascar MD MRCP ^* , H Devakumar MBBS , E Jungmann FRCP MSc , A Copas PhD , G Arthur MD MRCP   and D Mercey FRCP ^* 

^* The Mortimer Market Centre, Department of Genito-Urinary Medicine, Camden PCT; Archway Sexual Health Clinic, Camden PCT; Centre for Sexual Health and HIV Research, University College London, London, UK

Correspondence to: Dr R Monica Lascar, The Mortimer Market Centre, Camden PCT, London WC1H 6AU, UK Email: monix{at}doctors.net.uk

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.

Key Words: diagnosis • women • microscopy • lower vaginal infections

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