Brief Answer:
The HVS specimen result shows normal findings- details below

Detailed Answer:
Hello,

The high vaginal sample (HVS) you have had shows normal results. It is normal to have epithelial cells as long as they are not clustered (there is no indication on the result you mention that there are cluster cells).
The number of of white blood cells (pus) and red blood cells (RBC) are within normal limits as well.
It seems there is no vaginal yeast identified and no trichomonas vaginalis parasites.

It is normal to have some gram positive bacilli in the specimen as they are normal flora for the vaginal area.

It is unclear in the result the pus cells as once they are mentioned 4-6 cells/HPF (which is normal) and towards the end, next to gram positive bacillus is mentioned again pus cells ++, which of the two is the real result?
The fact that the culture did not show any growth in 48 hours means you don't have chlamydia and gonorrhea either.

So in total i would say that the findings in your HVS specimen are normal with normal epithelial cells, normal bacterial flora and no yeast, no trichomonas or other sexually transmitted disease identified.

Hope I have answered your query. Let me know if I can assist you further (in case more clarification is needed please upload the test results so i can assist you better)

Regards,
Dr. Antoneta Zotaj
General & Family Physician

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Brief Answer:
The HVS specimen result shows normal findings- details below

Detailed Answer:
Hello,

The high vaginal sample (HVS) you have had shows normal results. It is normal to have epithelial cells as long as they are not clustered (there is no indication on the result you mention that there are cluster cells).
The number of of white blood cells (pus) and red blood cells (RBC) are within normal limits as well.
It seems there is no vaginal yeast identified and no trichomonas vaginalis parasites.

It is normal to have some gram positive bacilli in the specimen as they are normal flora for the vaginal area.

It is unclear in the result the pus cells as once they are mentioned 4-6 cells/HPF (which is normal) and towards the end, next to gram positive bacillus is mentioned again pus cells ++, which of the two is the real result?
The fact that the culture did not show any growth in 48 hours means you don't have chlamydia and gonorrhea either.

So in total i would say that the findings in your HVS specimen are normal with normal epithelial cells, normal bacterial flora and no yeast, no trichomonas or other sexually transmitted disease identified.

Hope I have answered your query. Let me know if I can assist you further (in case more clarification is needed please upload the test results so i can assist you better)

Regards,
Dr. Antoneta Zotaj
General & Family Physician

---

Brief Answer:
There seem to be increased pus cells- explanation below

Detailed Answer:
Hello,

Thank you for uploading the results.
It seems that there is an increase in the pus cell number in Gram stain ( a stain for the cells that makes them more visible).
Increased pus cells are not typical of any specific condition and should be interpreted in the context of the symptoms.
Sometimes the lack of yeast or tricomonas in the microscopy might not necessarily mean they are not there as the microscopy can find tricomonas in 60% of cases and yeast in little higher percentage. Even the culture for chlamydia and gonorrhea does not have a 100% sensitivity.
Your symptoms and for how long they have been there are very important: presence of itchiness, abdominal pain, pain during intercourse, bad odor with secretions, nausea, lesions at the vulvar area (outside), fish odor, thick white secretions, urinary complaint, etc. Any new partners recently, or any similar complaints from your partner, etc.

So to conclude:
- you do have increased pus cells in the specimen which may indicate that there is an inflammation and a reaction of the body against something locally but is not specific to a certain condition.
- some of the infections are not ruled out or diagnosed 100% with the test so they might come out normal but still the patient might have them (as explained above)
- the clinical correlation with the results is important (your symptoms and what the doctor found in gynecological examination). The reason for the test is important: itchyness and thick white secretions very likely are due to yeast infection, pelvic pain with secretions with odor and pain during intercourse is very likely due to sexually transmitted disease, thin greenish bad odor secretions with itchiness and irritation might be due to trichomonas, secretions that smell like fish might be due to bacterial vaginosis, etc.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj
General & Family Physician

---

Brief Answer:
There seem to be increased pus cells- explanation below

Detailed Answer:
Hello,

Thank you for uploading the results.
It seems that there is an increase in the pus cell number in Gram stain ( a stain for the cells that makes them more visible).
Increased pus cells are not typical of any specific condition and should be interpreted in the context of the symptoms.
Sometimes the lack of yeast or tricomonas in the microscopy might not necessarily mean they are not there as the microscopy can find tricomonas in 60% of cases and yeast in little higher percentage. Even the culture for chlamydia and gonorrhea does not have a 100% sensitivity.
Your symptoms and for how long they have been there are very important: presence of itchiness, abdominal pain, pain during intercourse, bad odor with secretions, nausea, lesions at the vulvar area (outside), fish odor, thick white secretions, urinary complaint, etc. Any new partners recently, or any similar complaints from your partner, etc.

So to conclude:
- you do have increased pus cells in the specimen which may indicate that there is an inflammation and a reaction of the body against something locally but is not specific to a certain condition.
- some of the infections are not ruled out or diagnosed 100% with the test so they might come out normal but still the patient might have them (as explained above)
- the clinical correlation with the results is important (your symptoms and what the doctor found in gynecological examination). The reason for the test is important: itchyness and thick white secretions very likely are due to yeast infection, pelvic pain with secretions with odor and pain during intercourse is very likely due to sexually transmitted disease, thin greenish bad odor secretions with itchiness and irritation might be due to trichomonas, secretions that smell like fish might be due to bacterial vaginosis, etc.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj
General & Family Physician

---

Brief Answer:
It seems less likely to be a sexually transmitted infection- other possible causes explained

Detailed Answer:
Hello,

Low abdominal pain can be caused by many different causes and infections is one of them but not the only one. Because you don't have increased secretions with bad odor, no itchiness and have not been sexually active very likely sexually transmitted infections are not the cause in your case so I would not worry about this.

If the pain has stopped and you don't have it now very likely it was a self limiting condition. Generally the bowel can give low abdominal pain as well, especially if constipated or while having a viral infection (this gets better on its own within a few days). Sometimes during the time of ovulation, in the days between the two menstrual periods we can have pain on one of the ovaries while the egg is produced and lasts 1-2 days. Conditions of the uterus like fibroids (benign growths) can also sometimes cause some pain.

To conclude i would say:
- by what you explain and by examining the HVS it is less likely for you to have a gynecological infection causing you the low abdominal pain
- because the pain is better very likely other self limiting conditions can be considered
- if the pain comes back you will need to have a visit with the doctor, not just tests, as the tests can be misleading if not correlated with the clinical side (the symptoms of the patient).
- the doctor other than a general examination, might also need to do a gynecological visit in that case and check for redness, tenderness, how the secretions look, local lesions, etc, which in itself gives him a lot of information on the cause of your symptoms.
- if you feel constipated make sure you take extra fiber daily (over the counter in pharmacy), plenty of fruit and vegetables and if not enough you can take lactulose syrup 1-2 tablespoon a day to help soften the stools.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj
General & Family Physician

---

Brief Answer:
It seems less likely to be a sexually transmitted infection- other possible causes explained

Detailed Answer:
Hello,

Low abdominal pain can be caused by many different causes and infections is one of them but not the only one. Because you don't have increased secretions with bad odor, no itchiness and have not been sexually active very likely sexually transmitted infections are not the cause in your case so I would not worry about this.

If the pain has stopped and you don't have it now very likely it was a self limiting condition. Generally the bowel can give low abdominal pain as well, especially if constipated or while having a viral infection (this gets better on its own within a few days). Sometimes during the time of ovulation, in the days between the two menstrual periods we can have pain on one of the ovaries while the egg is produced and lasts 1-2 days. Conditions of the uterus like fibroids (benign growths) can also sometimes cause some pain.

To conclude i would say:
- by what you explain and by examining the HVS it is less likely for you to have a gynecological infection causing you the low abdominal pain
- because the pain is better very likely other self limiting conditions can be considered
- if the pain comes back you will need to have a visit with the doctor, not just tests, as the tests can be misleading if not correlated with the clinical side (the symptoms of the patient).
- the doctor other than a general examination, might also need to do a gynecological visit in that case and check for redness, tenderness, how the secretions look, local lesions, etc, which in itself gives him a lot of information on the cause of your symptoms.
- if you feel constipated make sure you take extra fiber daily (over the counter in pharmacy), plenty of fruit and vegetables and if not enough you can take lactulose syrup 1-2 tablespoon a day to help soften the stools.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj
General & Family Physician

---

Brief Answer:
Its a pleasure to be able to help you

Detailed Answer:
Its a pleasure,

I am glad we were able to help you. It is great that it is constipation likely the cause as it is easily treated and not anything to worry. Just follow the advises on how to treat constipation mentioned above.

If no improvement is noticed or you have any worsening please see your doctor.


Regards,
Dr. Antoneta Zotaj
General & Family Physician

---

Brief Answer:
Its a pleasure to be able to help you

Detailed Answer:
Its a pleasure,

I am glad we were able to help you. It is great that it is constipation likely the cause as it is easily treated and not anything to worry. Just follow the advises on how to treat constipation mentioned above.

If no improvement is noticed or you have any worsening please see your doctor.


Regards,
Dr. Antoneta Zotaj
General & Family Physician

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