Research Article| Volume 9, ISSUE 3, P525-533, September 1989


  • Carol A. Spiegel
    Corresponding author: Department of Pathology and Laboratory Medicine, University of Wisconsin Hospital and Clinics, 600 Highland Avenue A4/204, Madison, WI 53792.
    Assistant Professor, Department of Medical Microbiology and Immunology, University of Wisconsin; Director, Clinical Microbiology, Department of Pathology and Laboratory Medicine, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.
      In the premenopausal woman, vaginal infections may be caused by yeasts, Trichomonas vaginalis, and bacteria (bacterial vaginosis). None of these infections can be diagnosed by physical examination alone. Yeast vaginitis is diagnosed by microscopic detection of budding yeasts or pseudohyphae. The most sensitive method for detection of Trichomonas is culture, but the less sensitive microscopic methods are often used. Bacterial vaginosis is diagnosed by the presence of characteristic signs or by the presence of an altered vaginal flora as detected by Gram stain.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.


      Subscribe to Clinics in Laboratory Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Amsel R.
        • Totten P.A.
        • Spiegel C.A.
        • et al.
        Nonspecific vaginitis: Diagnostic criteria and microbial and epidemiologic associations.
        Am J Med. 1983; 74: 14
        • Blackwell A.L.
        • Fox A.R.
        • Phillips I.
        • et al.
        Anaerobic vaginosis (non-specific vaginitis): Clinical, microbiological, and therapeutic findings.
        Lancet. 1983; 2: 1379
        • Brady W.K.
        • Paine D.D.
        • Frye F.P.
        • et al.
        Evaluation of new plastic envelope miscrobiology (PEM) methods as adjuncts in the diagnosis of Candida albicans and Trichomonas vaginalis vaginitis.
        Mil Med. 1986; 151: 478
        • Brand J.M.
        • Galask R.P.
        Trimethylamine: The substance mainly responsible for the fishyodor often associated with bacterial vaginosis.
        Obstet Gynecol 1. 1986; 68: 682
        • Chen K.C.S.
        • Amsel R.
        • Eschenbach D.A.
        • et al.
        Biochemical diagnos is of vaginitis: Determination of diamines in vaginal fluid.
        J Infect Dis. 1982; 145: 337
        • Eschenbach D.A.
        • Buchanan T.M.
        • Pollock H.M.
        • et al.
        Polymicrobial etiology of acutepelvic inflammatory disease.
        N Engl J Med. 1973; 293: 166
        • Eschenbach D.A.
        • Hillier S.
        • Critchlow C.
        • et al.
        Diagnosis and clinical manifestations of bacterial vaginosis.
        Am J Obstet Gynecol. 1988; 158: 819
        • Fripp P.J.
        • Mason P.R.
        • Super H.
        A method for the diagnosis of Trichomonas vaginalis using acridine orange.
        J Parasitol. 1975; 61: 966
        • Gardner H.L.
        • Dukes C.D.
        Hemophilus vaginalis vaginitis.
        Am J Obstet Gynecol. 1955; 69: 692
        • Gravett M.G.
        • Nelson P.
        • DeRouen T.
        • et al.
        Independent association of bacterial vaginosis and Chlamydia trachomatis infection with adverse pregnancy outcome.
        JAMA. 1986; 67: 1899
        • Greenwood J.R.
        • Kirk-Hillaire K.
        Evaluation of acridine orange stain for detection of Trichomonas vaginalis in vaginal specimens.
        J Clin Microbiol. 1981; 14: 699
        • Hillier S.L.
        • Martius J.
        • Krohn M.
        • et al.
        A case-control study of chorioamnionic infection and histologic chorioamnionitis in prematurity.
        N Engl J Med. 1988; 319: 972
        • Horowitz B.J.
        • Edelstein S.W.
        • Lippman L.
        Candida tropicalis vulvovaginitis.
        Obset Gynecol. 1985; 66: 229
        • Koutsky L.A.
        • Stamm W.E.
        • Brunham R.C.
        • et al.
        Persistence of Mycoplasma hominis after therapy: Importance of tetracycline resistance and of coexisting vaginal flora.
        Sex Transm Dis. 1983; 11: 374
        • Krieger J.N.
        • Tam M.R.
        • Stevens C.E.
        • et al.
        Diagnosis of trichomoniasis conventional wet-mount examination with cytological studies, culture, and monoclonal antibody staining of direct specimens.
        JAMA. 1988; 259: 1223
        • Philip A.
        • Carter-Scott P.
        • Rogers C.
        An agar culture technique to quantitate Trichomonsas vaginalis from women.
        J Infect Dis. 1987; 155: 304
        • Rabe L.K.
        • Winterscheid K.K.
        • Hillier S.L.
        Association of viridans group streptococci from pregnant women with bacterial vaginosis and upper genital tract infection.
        J Clin Microbiol. 1988; 26: 1156
        • Smith R.F.
        Detection of Trichomonas vaginalis in vaginal specimens by direct immunefluorescence assay.
        J Clin Microbiol. 1986; 24: 1107
        • Smith R.F.
        Incubation time, second blind passage, and cost considerations in the isolation of Trichomonas vaginalis..
        J Clin Microbiol. 1986; 24: 139
        • Sobel J.D.
        Management of recurrent vulvovaginal candidiasis with intermittent ketoconazole prophylaxis.
        Obstet Gynecol. 1985; 65: 435
        • Spiegel C.A.
        • Amsel R.
        • Eschenbach D.A.
        • et al.
        Anaerobic bacteria in nonspecific vaginitis.
        N Engl J Med. 1980; 303: 601
        • Spiegel C.A.
        • Amsel R.
        • Holmes K.K.
        Diagnosis of bacterial vaginosis by direct Gram-stain of vaginal fluid.
        J Clin Microbiol. 1983; 18: 170
        • Thomason J.L.
        • Gelbart S.M.
        • Sobun J.F.
        • et al.
        Comparison of four methods to detect Trichomonas vaginalis..
        J Clin Microbiol. 1988; 26: 1869
        • Thomason J.L.
        • Gelbart S.M.
        • Wilcoski L.M.
        • et al.
        Proline aminopeptidase activity as a rapid diagnostic test to confirm bacterial vaginosis.
        Obstet Gynecol. 1988; 71: 607
        • Totten P.A.
        • Amsel R.
        • Hale J.
        • et al.
        Selective differential human blood bilayer media for isolation of Gardnerella (Haemophilus) vaginalis..
        J Clin Microiol. 1982; 15: 141
        • Watt R.M.
        • Philip A.
        • Wos S.M.
        • et al.
        Rapid assay for immunological detection of Trichomonas vaginalis..
        J Clin Microbiol. 1986; 24: 551
        • Yule A.
        • Gellan M.C.A.
        • Oriel J.D.
        • et al.
        Detection of Trichomonas vaginalis antigen in women by enzyme immunoassay.
        J Clin Pathol. 1987; 40: 566