The medical diagnosis with the highest percentage (57.9%) was bacterial vaginosis which did not correspond with laboratory data, that according to Amsel criteria
, only 15.8% 1had a diagnosis of bacterial vaginosis; however there was a better match with vaginal candidiasis diagnosis in terms of percentage.
In this study, Amsel criteria
diagnosed 43% of women suffering from bacterial vaginosis.
I think the presence of WBC may be helpful, but if your laboratory is using only the Amsel criteria
, reporting WBC is not one of the parameters.
Utility of Amsel criteria
, Nugent score, and quantitative PCR for Gardnerella vaginalis, Mycoplasma hominis, and Lactobacillus spp.
PCR assays have advantage over the two most commonly used methods for detecting lower genital tract bacteria; the Amsel criteria
and the Gram stain, in that it is more sensitive.
Five hundred forty-four women (mean age, 33 years) with bacterial vaginosis diagnosed by the Amsel criteria
or the Nugent scoring system were randomly assigned to receive, in double-blind fashion, 2 oral capsules per day of the combination of Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 (GR-1/RC-14; more than 109 colony-forming units of each strain per capsule) or placebo for 6 weeks.
The 10 who returned for a checkup 1 month later were in remission, with no symptoms, no clue cells, a negative amine test result, and no more than one of four Amsel criteria
. Nine of the 10 were still in remission at the 3-month checkup, when treatment was discontinued, Dr.
Diagnosis of BV has traditionally relied on the Amsel criteria
, where the clinician confirms the presence of 3 out of 4 criteria: vaginal discharge, vaginal-fluid pH >4.5, a positive "whiff" test, and microscopic examination of clue cells.
BV is caused by an overgrowth of Gardnerella vaginalis (G.vaginalis), anaerobes, Mycoplasma hominis (M.hominis), Ureaplasma urealyticum (U.urealyticum) and clinically diagnosed by Amsel criteria
: presence of thin, grayish homogenous discharge; vaginal pH greater than 4.5; presence of clue cells, positive whiff test (detection/enhancement of fishy odor on additions of potassium hydroxide to the vaginal specimen).
The primary end point was the diagnosis in the first 2 months of BV using Amsel criteria
: the presence of thin, grey-white homogenous discharge coating the vaginal walls; vaginal pH >4.5; a positive whiff-amine test (presence of "fish smell" with potassium hydroxide [KOH] or KOH prep); and the presence of clue cells on normal saline wet mount.
Utility of Amsel criteria
, Nugent's score and quantitative PCR for Gardnerella vaginalis, Mycoplasma hominis and Lactobacillus spp.