Department of Obstetrics and Gynecology, Campus Innenstadt, Ludwig-Maximilians-University Munich, Munich, Germany.
Obstet Gynecol Surv. 2011 Jun;66(6):359-68. doi: 10.1097/OGX.0b013e31822bdf31.
Vaginal discharge is highly variable in quality and quantity among different individuals, and even in the same individual during different periods of life. Vaginal discharge is most commonly caused by infection with sexually transmitted organisms or increased colonization by different facultative pathogenic microorganisms (i.e., Gardnerella vaginalis). Noninfectious causes of vaginal discharge are quite rare (10% noninfectious as compared to 90% infectious causes). Most common in women with a vaginal infection is bacterial vaginosis (40%-50% of cases), followed by vulvovaginal candidosis (20%-25%), and then trichomoniasis (15%-20%). If infection is suspected as the primary cause, a sample of the vaginal discharge should be taken and examined microscopically. When evaluating vaginal secretions by phase-contrast wet mount microscopy, knowledge of what is normal versus abnormal is very important. Knowledge of the sensitivity and specificity of wet mount microscopy in different clinical settings is also important.
Obstetricians & Gynecologists, Family Physicians
After completing this CME activity, physicians should be better able to evaluate lifetime changes in vaginal secretions, characterize the physiological and pathological appearance of vaginal discharge, assess the clinical practicality and usefulness of wet mount microscopy and use wet mount microscopy to diagnose bacterial vaginosis and other common vaginal infections.
不同个体的阴道分泌物在质量和数量上存在很大差异，即使在同一个体的不同生命阶段也是如此。阴道分泌物最常见的原因是感染性传播病原体或不同兼性致病微生物（即阴道加德纳菌）的过度定植。非感染性原因引起的阴道分泌物很少见（非感染性原因占 10%，而感染性原因占 90%）。在阴道感染的女性中，细菌性阴道病最为常见（占 40%-50%），其次是外阴阴道念珠菌病（占 20%-25%），然后是滴虫病（占 15%-20%）。如果怀疑感染是主要原因，应采集阴道分泌物样本并进行显微镜检查。在通过相差湿镜检查评估阴道分泌物时，了解正常与异常的区别非常重要。了解不同临床环境中湿镜检查的敏感性和特异性也很重要。
妇产科医师、家庭医生
完成这项 CME 活动后，医生应能更好地评估阴道分泌物在整个生命周期中的变化，描述阴道分泌物的生理和病理表现，评估湿镜检查的临床实用性和有用性，并使用湿镜检查诊断细菌性阴道病和其他常见阴道感染。
