Ventolini Gary, Gandhi Kushal, Manales Nathan Joshua, Garza John, Sanchez Asley, Martinez Brianna
Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA.
The University of Texas Permian Basin, Odessa, Texas, USA.
J Family Reprod Health. 2022 Jun;16(2):102-105. doi: 10.18502/jfrh.v16i2.9477.
In women's health, clinicians are often faced with diagnosing and administering treatment to patients who present with an increased vaginal discharge without much other information to work with. It's only once a patient's background is reviewed and lab work is completed that two common reasons behind vaginal discharge with similar symptoms, Lactobacillosis and Cytolytic Vaginitis, can be differentiated and a proper diagnosis can be reached. Now, we understand that Lactobacillosis and Cytolytic Vaginitis are symptomatically confused by patients as well as inexperienced clinicians. Lactobacillosis involves the presence of abnormal, extremely long Lactobacilli, a keystone species for vaginal health, while Cytolytic Vaginitis mainly involves, increased Lactobacilli, pH between 3.5 and 4.5, presence of cytolysis, and a lowered white blood cell count. Both present with similar discharge, leading to their conflation. A microscopic examination of the discharge using a wet mount with normal saline can provide 80% diagnostic sensitivity until further testing can be completed.
在女性健康领域，临床医生常常面临这样的情况：要对阴道分泌物增多但缺乏其他可用信息的患者进行诊断和治疗。只有在回顾患者背景并完成实验室检查后，才能区分阴道分泌物增多且症状相似的两个常见原因——乳杆菌病和细胞溶解性阴道炎，并做出准确诊断。现在我们知道，患者以及经验不足的临床医生在症状上会将乳杆菌病和细胞溶解性阴道炎混淆。乳杆菌病表现为存在异常的、极长的乳杆菌，这是维持阴道健康的关键菌种，而细胞溶解性阴道炎主要表现为乳杆菌增多、pH值在3.5至4.5之间、存在细胞溶解现象以及白细胞计数降低。两者都有相似的分泌物，导致它们被混淆。在完成进一步检测之前，使用生理盐水湿片对分泌物进行显微镜检查可提供80%的诊断敏感性。
