[Diagnosis of vaginal discharge].
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By inoculation of the yolk sac of embryonating hen eggs and a commercial available enzyme amplified immunoassay to detect chlamydial antigen 63 samples of purulent vaginal discharge from heifers with Chlamydia-induced endometritis were tested for chlamydiae. Vaginal mucus samples from 42 slaughter cattle without any signs of vaginitis/endometritis and 14 samples from various pyogenic bovine infections served as controls. Chlamydiae were isolated from 44 of 63 samples from the experimentally infected heifers. None of the 66 controls gave a positive response neither in the yolk sac culture nor in the ELISA. The overall correlation of the ELISA with culture was 89.9%. Analysis of the ELISA-results revealed the discordance between ELISA and culture presumably to be caused by false negative results in the hen egg technique.
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A group of general practitioners in active practice were asked to report how they preferred to manage the symptoms of vaginal discharge presented by a woman in her twenties. Subsequently the same practitioners reported their management of such patients in their practice.A shortfall was found for all practitioners between their declared intention and their actual practice.This method of analysis offers a way of working towards a consensus in clinical care and also of auditing medical performance in general practice.
Three hundred and thirty pregnant Black antenatal patients with symptomatic vaginal discharge were assessed. There appeared to be no correlation between the symptoms (pruritus, burning, amount of discharge and appearance) and the expected diagnosis. The common organisms Trichomonas vaginalis, Haemophilus vaginalis, Candida albicans and Neisseria gonorrhoeae were evaluated. It was also noted that a large number of patients (54%) had negative cultures although their complaints were similar to those of patients with positive cultures.
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The importance of the vomeronasal (accessory olfactory) system for the copulatory responses of male hamsters to a high molecular weight fraction (HMF) of vaginal discharge was assessed in animals that had their vomeronasal organs (VNO) removed. These organs were extirpated bilaterally using an oral approach through the palate so as to eliminate the peripheral afferents to the accessory olfactory bulb (AOB) with minimal or no damage to the main olfactory system. The selective peripheral deafferentation procedure was verified by applying horseradish peroxidase intranasally following intraperitoneal injections of epinephrine to facilitate the vomeronasal pumping mechanism that draws fluids into the VNO. Heavy, bilateral anterograde labeling was evident in the olfactory nerve afferents within the main olfactory bulb of males that had their VNO removed and of animals that received sham surgery. Sham-operated males also had heavy, bilateral labeling in the vomeronasal nerve afferents within the AOB, whereas no such labeling occurred among animals with bilateral removal of the VNO. In sham-operated animals, both the HMF and the unfractionated discharge significantly increased the incidence of intromission attempts toward anesthetized males (surrogate females) whose hindquarters were scented with these stimuli. The unfractionated discharge also produced a significant elevation of overt copulatory behavior in males with selective peripheral deafferentation of the vomeronasal system, whereas the HMF did not facilitate copulatory behavior in these animals.(ABSTRACT TRUNCATED AT 250 WORDS)
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Haemagglutination and tissue culture adherence tests using a McCoy cell line were used to examine the adherence characteristics of 105 strains of Gardnerella vaginalis. Each strain represented one isolate per patient. For each patient, a direct smear of vaginal discharge was examined for clue cells. The relation between in vitro adherence and the presence of clue cells was examined. There seemed to be no appreciable relation between the presence of clue cells in smears and the haemagglutinating activity of strains. In contrast, adherence as judged by the McCoy tissue culture system showed a significant relation to the presence of clue cells (p less than 0.001). Though both adhesive characteristics were not inhibited by mannose, the mechanism of haemagglutination of human red cells appeared to differ from that of adherence of tissue culture cells. The findings imply that the clue cell phenomenon is due to attachment of adherent strains of G vaginalis to epithelial cells. Adherent strains of G vaginalis may play a part in the pathogenesis of bacterial vaginosis.
We report on a 22-year old patient with an ectopic ureter ending in the vestibulum of the vagina without genital malformations. Generally, the diagnosis of this anomaly will have already been made in childhood, because of enuresis uretica and therapy-resistant vaginal discharge. The methods of diagnosis leading to this anomaly, which is rare at that age, and the therapeutic requirements are shown.
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BACKGROUND: Female genital tuberculosis is an uncommon disease that is rarely diagnosed in developed countries. CASE PRESENTATION: A 61-year-old postmenopausal woman who had undergone surgery and treated with adjuvant chemotherapy for infiltrating ductal carcinoma of the breast five years ago, presented with bloody vaginal discharge, fatigue, weight loss, and low grade fevers at night for two months. Histological examination of the endometrium, done based on the suspicion of a second primary cancer due to the tamoxifen therapy, revealed a granulomatous reaction. Liquid and solid mycobacterial cultures of the tissues were performed. Although the acid fast staining was negative, the liquid culture was positive for Mycobacterium tuberculosis. Involvement of other systems was not detected. The patient was treated with a three-drug antituberculosis regimen for 9 months and recovered fully. CONCLUSION: Female genital tuberculosis is a rare but curable disease that should be included in the differential diagnosis of women with menstrual problems. Early diagnosis is important and may prevent unnecessary invasive procedures for the patient.
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