Abstract
Background: The abnormal vaginal discharge in reproductive age group is a common clinical problem for female. It is the second most common problem after abnormal uterine bleeding. It is a neglected health problem, most commonly caused due to vulvovaginal candidiasis, and bacterial vaginosis (BV).
Objectives: The present study was studied to know the prevalence of common organisms causing vaginal discharge and also to know the variety of clinical presentation.
Materials and Methods: In this prospective study 100 women in the reproductive age were participated who were complained unusual discharge at Out patients department of Ostetrics and Gynaecology, IMS and SUM hospital, Bhubaneswar, between September 2012 and September 2014. A total of 100 women in the reproductive age group who had symptoms of vaginitis were examined. Data were coded and analyzed.
Results: Out of the 100 patients examined, 77 (77%) cases were organism positive. Among the positive cases, BV (27%) was the most common microbiological cause of abnormal vaginal discharge, followed by trichomoniasis (25%), vaginal candidiasis (22%), combined infection (Candida and BV) (3%), and nonspecific cases (23%).
Conclusion: Out of 100 cases, few cases showed discordance between clinical and laboratory diagnosis. This discordance can be due to pitfalls in identifying the causative agent clinically or obscuring of the findings due to improper treatment received for other ailments. Thus, clinico-investigative correlation is more important than other clinical findings alone.
Keywords: Bacterial vaginosis, candidiasis, nonspecific vaginitis, trichomoniasis.
References
- Yudkin G. Vaginal discharge. In: McPherson AA, editor. Women's Problems in General Practice. 2nd ed. Oxford: Oxford University Press; 1988.
- O'Dowd TC, West RR, Ribeiro CD, Smail JE, Munro JA. Contribution of Gardnerella vaginalis to vaginitis in a general practice. Br Med J (Clin Res Ed) 1986;292:1640–2.
- Fox KK, Behets FM. Vaginal discharge. How to pinpoint the cause. Postgrad Med. 1995;98:87.
- Macsween KF, Ridgway GL. The laboratory investigation of vaginal discharge. J Clin Pathol. 1998;51:564–7. Epidemiology and clinico-investigative study of organisms causing vaginal discharge https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389219/?report=printable 9 of 23 11/27/2017 10:09 AM
- Cullins VA, Dominguez L, Guberski T, Secor RM, Wysocki SJ. Treating vaginitis. Nurse Pract. 1999;24:46, 49.
- Abdullah Yusuf Md, Chowdhury M, Shahidul Islam KM, Eva EO, Sharif AR, Khalilur Rahman Md, et al. Common microbial etiology of abnormal vaginal discharge among sexually active women in Dhaka, Bangladesh. South East Asia J Public Health. 2011;1:35–9.
- Cerikcioglu N, Beksac MS. Cytolytic vaginosis: Misdiagnosed as candidal vaginitis. Infect Dis Obstet Gynecol. 2004;12:13–6.
- Al Quaiz JM. Patients with vaginal discharge: A survey in a university primary care clinic in Riyadh city. Ann Saudi Med. 2000;20:302–6.
- Koumans EH, Sternberg M, Bruce C, McQuillan G, Kendrick J, Sutton M, et al. The prevalence of bacterial vaginosis in the United States, 2001-2004; associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis. 2007;34:864–9.
- Pawanarkar J, Chopra K. Health and population – Prevalence of lower reproductive tract infection in infertile women. Perspect Issues. 2004;27:67–75.
- Gupta N, Zahn MM, Coppens I, Joiner KA, Voelker DR. Selective disruption of phosphatidylcholine metabolism of the intracellular parasite Toxoplasma gondii arrests its growth. J Biol Chem. 2005;280:16345–53.
- Nessa A, Nahar KN, Begum SA, Anwary SA, Hossain F, Nahar K. Comparison between visual inspection of cervix and cytology based screening procedures in Bangladesh. Asian Pac J Cancer Prev. 2013;14:7607–11.
- Chowdhury MN, Jabbar FA, Kambal AM. Isolation of Gardnerella vaginalis from high vaginal swabs. Trop Geogr Med. 1985;37:328–33.
- Madhivanan P, Hari A, Kumarasamy N, Kausalya AG, Suniti Solomon LJ, YR Gaitonde. Profile of HIV infected pregnant women and interventions used in prevention of vertical transmission of HIV in tertiary HIV care centre. J Obstet Gynaecol India.2002;53:3–7.
- Bukusi EA, Cohen CR, Stevens CE, Sinei S, Reilly M, Grieco V, et al. Effects of human immunodeficiency virus 1 infection on microbial origins of pelvic inflammatory disease and on efficacy of ambulatory oral therapy. Am J Obstet Gynecol. 1999;181:1374–81.
- Bachmann LH, Hobbs MM, Seña AC, Sobel JD, Schwebke JR, Krieger JN, et al. Trichomonas vaginalis genital infections: Epidemiology and clinico-investigative study of organisms causing vaginal discharge https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389219/?report=printable 10 of 23 11/27/2017 10:09 AM progress and challenges. Clin Infect Dis. 2011;53:S160–72
- Lally P, van Jaarsveld CH, Potts HW, Wardle J. How are habits formed: Modelling habit formation in the real world. Eur J Soc Psychol. 2010;40:998–1009.
- Nwadioha SI, Egah DZ, Banwat EB, Alao OO. Microbial agent of abnormal vaginal discharge in pregnant mothers attending primary health care centers of Jos, Nigeria. J Clin Med Res. 2010;2:7–11.
- Verbalis JG, Mangione MP, Stricker EM. Oxytocin produces natriuresis in rats at physiological plasma concentrations. Endocrinology. 1991;128:1317–22.
- Saxena U, Yadav S. STD prevalence in sexually active women attending the STD clinic of a tertiary level general hospital. J Obstet Gynaecol India. 2001;51:134–7.
- Caillouette JC, Sharp CF, Jr, Zimmerman GJ, Roy S. Vaginal pH as a marker for bacterial pathogens and menopausal status. Am J Obstet Gynecol. 1997;176:1270–5.
Corresponding Author
Dr Rajesh Lenka
Associate Professor, Department of Microbiology,
IMS and SUM hospital, Siksha “O” Anusandhan University, K8,
Kalinganagar, Bhubaneswar-751003, Odisha, India
DOI: https://dx.doi.org/10.18535/jmscr/v5i12.26
