Diagnosing Vaginal Infections with the Wet Prep Procedure

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Wet Prep Procedure Reporting 1. Trichomonas - Positive - Negative 2. PMN’s PMN Normal: if = 10 PMN’s/hpf PMN s/hpf PROCEDURE NOTES It is very important that specimens be examined within one hour after collection. After one hour, Trichomonads lose their motility. LIMITATIONS Wet preps have been reported to detect T. vaginalis in 52-75% 52 75% of infected patients. Other alternative diagnostic methods include culture, monoclonal antigen detection kits and permanent stained smears. Trichomoniasis: Trichomoniasis Other Diagnostic Tests •Saline suspension - 52 – 75% sensitivity •pH >4.5 •Positive Whiff test •Stained Slide prep (Pap Smear) •Culture – Gold Standard •PCR 84% sensitivity – currently research only •Trichomonas Rapid Test – antigen detection •Nucleic acid probe tests for T. vaginalis, Candida albicans, and Gardnerella vaginalis Diagnosis of T. vaginalis in Females PCR vs. Culture vs. Wet Mount Sensitivity (% ) 90 80 70 60 50 40 30 20 10 0 52% 78% 84% Wet Mount Culture PCR n= 337 women 24
Trichomoniasis Treatment: •Single Dose Therapy – 2gm oral metronidazole (Dosage used for pregnant patients after 37 th week – discontinue before breast feeding) 2gm Tinidazole (Category C)– not for pregnant patients •Alternate regimen - 500mg metronidazole bid for 7 days •Do not treat with metronidazole gel Treat sexual partner: Treat with metronidazole – 2 gm oral single dose Avoid intercourse until therapy completed and both patient and partner are asymptomatic. Trichomoniasis Treatment failures •Re-treat with: - 500mg metronidazole bid for 7 days - 2 gm tinidazole (single dose) - 2 gm per day for 5 days of either metronidazole or tinidazole Continued failure: •Consult infectious disease specialist •Send organism for metronidazole susceptibility testing to CDC Trichomoniasis Treatment of Sexual Partner • Treat with metronidazole or tinidazole – 2gm single dose • Avoid intercourse until therapy is completed and both patient and partner are asymptomatic 25
Page 1 and 2: Diagnosing Vaginal Infections with
Page 3 and 4: Gram stain of vaginal secretions co
Page 5 and 6: BV - Diagnosis Criteria 1. Malodoro
Page 7 and 8: Microscopic Findings for BV • Few
Page 9 and 10: Gram Stained Clue Cell and Normal S
Page 11 and 12: Treatment for Bacterial Vaginosis N
Page 13 and 14: Vulvovaginal Candidiasis Background
Page 15 and 16: Yeast budding forms and pseudohypha
Page 17 and 18: Yeast Vaginitis - Treatment • Top
Page 19 and 20: Prevalence in Female Population 40
Page 21 and 22: Wet Prep Procedure MATERIALS Reagen
Page 23: Trichomonas vaginalis Wet Prep Appe
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Diagnosing Vaginal Infections with the Wet Prep Procedure

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