Clinical manifestations of female trichomoniasis and comparison of direct microscopy and culture media in its diagnosis.

A group of 125 women attending a gynecologic clinic was studied to assess the value of four culture media, wet smear and Papanicolaou stained smears and also to re-evaluate the clinical picture in the diagnosis of trichomoniasis. There was no significant difference between the results of 4 different culture media but significant difference was obtained from fresh wet vaginal smears and culture media on the one hand and with Papanicolaou stained smears on the other hand. During the survey, cultures were examined daily for five days, and the Oxoid no. 2 medium gave a majority of positive results and diphasic eggs, CM161 Oxoid, 5447 Merck media were in turn having positive results after 3 days incubation at 36 degrees C. R27, egg, CM161 and 5447 culture techniques and Papanicolaou stained smears, identified T. vaginalis in 37 (29.6%), 33 (26.4%), 30 (24%), 28 (22.4%) and 15 (12%) patients respectively, while the wet mount was positive in 22 (17.6%) patients. R27 culture technique identified T. vaginalis in 37 women, and wet mount was positive in 22 patients (P greater than 0.001). In no case was the vaginal wet mount preparation positive for T. vaginalis and the culture negative. Egg medium detected T. vaginalis in 33 women, in comparison with wet mount positive 22 (P greater than 0.01). Vaginal discharge was described by 72% of the 125 patients, but only 19 (51.4%) Trichomonas vaginalis were detected. Dysuria was present in 73 (58.4%) cases but only 21 (16.8%) were suffering from trichomoniasis. Physical examination revealed no vaginal discharge in 18 (48.6%) of the women, 12 (22.4%) cases had frothy leukorrhea in women with trichomoniasis.