Article

Vaginal leucocyte counts in women with bacterial vaginosis: relation to vaginal and cervical infections.

Department of Medicine, University of Alabama at Birmingham, 35294-0007, USA.
Sexually Transmitted Infections (Impact Factor: 3.08). 11/2004; 80(5):401-5. DOI: 10.1136/sti.2003.009134
Source: PubMed

ABSTRACT To evaluate whether an elevated vaginal leucocyte count in women with bacterial vaginosis (BV) predicts the presence of vaginal or cervical infections, and to assess the relation of vaginal WBC counts to clinical manifestations.
We retrospectively analysed the relation of vaginal leucocyte counts to vaginal and cervical infections and to clinical manifestations in non-pregnant women diagnosed with BV at an STD clinic visit.
Of 296 women with BV studied, the median age was 24 years and 81% were African-American. Elevated vaginal leucocyte counts were associated with objective signs of vaginitis and cervicitis and also predicted candidiasis (OR 7.9, 95% CI 2.2 to 28.9), chlamydia (OR 3.1, 95% CI 1.4 to 6.7), gonorrhoea (OR 2.7, 95% CI 1.3 to 5.4), or trichomoniasis (OR 3.4, 95% CI 1.6 to 7.3). In general, as a screening test for vaginal or cervical infections, vaginal leucocyte count had moderate sensitivities and specificities, low positive predictive values, and high negative predictive values.
An elevated vaginal leucocyte count in women with BV was a strong predictor of vaginal or cervical infections. Vaginal leucocyte quantification may provide an alternative approach to assessing need for empirical therapy for chlamydia and gonorrhoea, particularly in resource-limited high STD risk settings that provide syndromic management.

0 Followers
 · 
83 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: De vaginale klachten waarvan de diagnostiek in dit hoofdstuk beschreven wordt, zijn: – niet-bloederige vaginale afscheiding die volgens de vrouw ongebruikelijk is wat betreft de hoeveelheid, de geur of de kleur; – jeuk of irritatie in of rond de schede.
    12/2003: pages 603-614;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Diagnosing bacterial vaginosis (BV) has long been based on the clinical criteria of Amsel et al., whereby three of four defined criteria must be satisfied. Though there are other criteria and scoring methods which function well in comparison (i.e. Nugent scoring), it is not certain that they will always identify the same category of patients. Point-of-care methods based on various combinations of microbial products, presence of RNA, or more complex laboratory instrumentations such as sensor arrays, have also been introduced for the diagnosis of BV. No method for diagnosing BV can at present be regarded as the best. It could be that--based partly on tacit knowledge on the part of the clinical investigators scoring in the clinic--various scoring systems have been chosen to fit a particular BV-related problem in a particular population. In this review we critically examine these pertinent issues influencing clinical scoring and laboratory diagnostics of BV.
    Apmis 04/2005; 113(3):153-61. DOI:10.1111/j.1600-0463.2005.apm1130301.x · 1.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The last decade has produced considerable advances in the diagnosis of the common etiologies of mucopurulent cervicitis (MPC), including Chlamydia trachomatis and Neisseria gonorrhoeae, and in the delineation of key aspects of their pathogenesis. Despite this, clear understanding of why these bacteria cause cervical inflammation in a minority of women who is infected with either organism is limited. Furthermore, many women who have MPC have neither of these infections detected, even when highly sensitive diagnostic tests are used. This article describes current data regarding this common condition, and charts new developments that might inform a more comprehensive understanding of MPC and its management, and of the more subtle signs of cervical inflammation that may impact women's susceptibility to a variety of infectious diseases, including HIV-1.
    Infectious Disease Clinics of North America 07/2005; 19(2):333-49, viii. DOI:10.1016/j.idc.2005.03.009 · 2.31 Impact Factor
Show more

Preview

Download
1 Download
Available from