Gram stain and Giemsa stain as a rapid diagnostic tool for diagnosis of vaginal infections” in Western Nepal

Abstract

Abstract: Introduction: Infective vaginitis accounts for about 90% of all the cases of vaginal discharge in the women of reproductive age group. This includes triad of bacterial vaginosis, candidiasis and trichomoniasis. Method: The study was carried out in Lumbini Medical College and Teaching Hospital, Palpa, Nepal for a time period of 4 months. Total 125 high vaginal swabs from posterior fornix of vagina were collected from November 2014 to February 2015 in the department of Obstetrics and Gynecology, in the patients complaining of vaginal discharge. PH of the vaginal discharge was also determined by using litmus paper. Gram’s and Giemsa stain of vaginal swab smear were done to diagnose Bacterial vaginosis, Candidiasis and Trichomoniasis. Age, parity and pregnancy status of the patients were noted. Result: Out of 125 patient, bacterial vaginosis was found in 16% and candidiasis in 37%.Candidiasis and bacterial vaginosis were observed in child bearing sexually active women. Surprisingly bacterial vaginosis was not observed in pregnant women. Trichomoniasis infection was present in one case (0.8%) while severe invasive Candidiasis was observed in one woman. Conclusion: A definitive diagnosis can easily be made by Gram’s and Giemsa stain and microscopic examination of high vaginal swab. This may help in specific treatment and  prevent associated morbidity and  recurrence. Key words: Bacterial vaginosis, candidiasis, high vaginal swab, Gram’s stain, Giemsa stain.