Research Article Clinical Microbiology and Infectious Diseases Clin Microbiol Infect Dis, 2016 doi: 10.15761/CMID.1000104 Volume 1(1): 17-19 ISSN: 2398-5763 Comparison of clinical and cytological fndings in the diagnosis of vulvovaginitis in adult women Celeste Maria de Menezes Souza 1 , Hugo Marcus Rodrigues 2 , Márcia Guimarães da Silva 3 , Camila Marconi 4 , Ricardo Ney Oliveira Cobucci 5 * and Ana Katherine Gonçalves 1 1 Gynecology and Obstetric Department, Universidade Federal do Rio Grande do Norte – UFRN, Natal, Brazil 2 Health Science Post Graduate Program, Universidade Federal do Rio Grande do Norte – UFRN, Natal, Brazil 3 Pathology Department, Universidade Estadual Paulista- UNESP,São Paulo, Brazil 4 Pathology Department, Universidade Estadual Paulista- UNESP,São Paulo, Brazil 5 Gynecology and Obstetric Department, Universidade Potiguar – UnP, Natal, Brazil Abstract Background: Inability to diagnose vulvovaginal infections is a growing concern. Specialist knowledge of how to prepare and assess wet mount slides for the diagnosis of vulvovaginitis is the exception. Aim: Tis study evaluated 200 women who complained about vaginal discharge to determine the accuracy of the methods available for the diagnosis of vulvovaginitis. Materials and methods: Vaginal smear was collected for microbiological tests (Pap smear, wet mount and Gram stain); the gram stain method was the gold standard. Te clinical diagnosis was based on signs and symptoms. Te efcacy of the available methods for diagnosis of vaginal discharge was assessed: sensitivity (S), specifcity (SP), positive predictive value (PPV) and negative predictive value (NPV). Results: Concerning Wet mount: Vaginal candidiasis (VC): S=31%; SP=97%; PPV=54%; NPV =93%; accuracy=91%. Bacterial vaginosis (BV): S=80%; SP =95%; PPV=80%; NPV=95%; accuracy=92%. Regarding Syndromic approach: BV: S=95%; SP=43%; PPV=30%; NPV=97%; accuracy=54%. VC: S=75%; SP =91%; PPV=26%; NPV=98%; accuracy=90%. Pap smear for VC: S=68%, SP=98%; PPV=86%; NPV =96%; accuracy=96%. BV: S=75%; SP=100%; PPV=100%; NPV =94%; accuracy=95%. Tere was only one case of vaginal trichomoniasis. Conclusion: Pap smear and wet mount showed respectively low and very low sensitivity for VC. Te syndromic approach showed very low specifcity and accuracy for BV. Correspondence to: Ricardo Ney Oliveira Cobucci, Gynecology and Obstetric Department, Universidade Potiguar – UnP, Natal, Brazil, Tel: +558420209051; E-mail: drcobucci@gmail.com Key words: diagnosis, candidiasis, bacterial vaginosis, trichomoniasis Received: May 29, 2016; Accepted: July 04, 2016; Published: July 08, 2016 Introduction Despite its tremendous practical importance, infectious diseases training in gynecology still leaves much to be desired [1,2]. Attempts to detect the underlying causes of symptoms may be carried out on a “trial and error” basis, resulting in unnecessary or inadequate microbiologic diagnostic investigations and antibiotic treatment which may not be suitable or may be insufcient or in the worst case, have adverse consequences for patients [2]. Ultimately, a correct diagnosis is not yielded. Inability to diagnose vulvovaginal infections is a growing concern. For various reasons, specialist knowledge of how to prepare and assess wet mount slides for microscopic investigation of vaginal discharge is the exception rather than the rule in outpatient clinics or hospitals [3-5]. In contrast to developed countries where regulations require wet mount profciency testing, gynecologists in Brazil do not currently need to prove their specialist knowledge in this area. Tis is an extremely welcome development, not least because the overwhelming number of uncomplicated vulvovaginal symptoms can already be diagnosed using basic diagnostic procedures; whereas the diagnosis of vulvovaginitis can usually be fairly straightforward based on the patientʼsmedical history, clinical examination with measurement of vaginal pH, whif test and evaluation of wet mount slides [1,2]. Te latter methods are usually also sufcient to diferentiate between normal vaginal fndings and vulvovaginitis with a relatively high degree of accuracy [1]. Te emphasis of this article is on basic diagnostic procedures that can be carried in the practice of a registered doctor or hospital at limited cost. Te purpose of the present study was to compare the current clinical and cytological diagnosis approaches on women with vulvovaginal discharge complaint. Materials and methods Tis study was conducted at a gynecology outpatient clinic between March 2014 and March 2015. Te study protocol was approved by the Local Ethics Committee (CAAE=17911813.4.0000.5292). All premenopausal women applying to our gynecology outpatient clinic with the vaginal discharge complaint were enrolled prospectively into the study afer written informed consent was obtained. Exclusion