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What Does My Vaginal Swab Test Report Indicate?

Posted on Mon, 1 Jun 2015

Question: My wife is pregnant and is in the first trimester. Her vaginal swab test indicated "fair amount of gram negative bacilli". Should we be concerned ?

Answered by Dr. Manisha Jain (32 minutes later)

Brief Answer:
report needed

Detailed Answer:
Hello Sir, thanks for trusting health care magic.
Can you please upload the report so that I can see the colony count and the antibiotic sensitivity if done and the strain of organism if mentioned.
In general many bacteria are normally present in female genital tract so normally present bacteria if are applied to the swab stick can give fallacious results and also in case colony count is less than 100,000 then also there is nothing to worry.
But in case there is significant infection then there are slightly increased risk of abortion and growth retarded baby.
So kindly send me the report so that I can advice you better.
Regards
Dr Manisha

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Jain (53 minutes later)

Thank you Dr XXXXXXX Appreciate your guidance with this. We are quite anxious and don't want to self diagnose with information available online. My wife doesn't have any irritation or burning sensation to indicate any infection.

The report is as below:
**********************************************
Specimen: Vaginal Swab

Gram Negative Diplococcus -
Intra Cellular: Not Found
Extra Cellular: Not Found

Other Organism: Gram Negative Bacilli found in fair numbers
Pus Cells: Found in fair numbers
Epithelial Cells: Found in fair numbers
Ratio P/E: 15:1
KOH Preparation: Fungal hyphae not found
Wet Film: Trichomonads not found

Culture & Sensitivity
Specimen of: Vaginal Swab
Organism Isolated: No Growth Obtained on routine aerobic culture
***************************************
I called up the pathology after your response to check on the the count and they told me that the count is not obtained with a vaginal swab test. It is obtained from Urine test.

We did do a urine test for her few days back - Routine Urine (Protein, Sugar, Microscopy) - Not sure if a presence of infection will be highlighted in this test or there is any other specific urine test for the same. Here are the results from the urine test:

Physical Examination
Colour: Pale Yellow
Specific Gravity: 1.010
Appearance: Slight Hazy

Chemical Examination
pH: 6.00
Glucose: Nill
Protein: Nill
Urobilinogen: 0.2 eu/dl
ketones: Nill
Nitrites: Nill

Microscopic Examination
PUS CELLS: 2-4/HPF
Epithelial Cells: 12-16/HPF
RBC: Not found

Please advise

Best Regards,
XXXX

Answered by Dr. Manisha Jain (2 hours later)

Brief Answer:
antibiotics prescribed

Detailed Answer:
Hi, sir, I appreciate your decision on not relying on vague online information.
In my opinion she needs to take tablet azithromycin 1 gram one tablet stat and also tablet cefixime 200 mg twice a day for 5 days.
Along with this ask her to use vWash liquid daily after bath which will help to maintain normal flora in the vaginal area and thus immunity against future infection.
Asymptomatic infection is less common in vaginal area and usually an incidental finding.
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Jain (22 minutes later)

Thank you doctor. Have couple of follow up questions:

1. Are there chances of the developing baby to be affected by the prescribed antibiotics ?

2. Regarding asymptomatic infection, although she doesn't have burning / foul odor / irritation but the color of her discharge is sometimes Greenish. Please let me know if this is normal ?

Regards

Answered by Dr. Manisha Jain (2 hours later)

Brief Answer:
Safe antibiotics

Detailed Answer:
No dear these antibiotics are safe for both mother and baby and thus nothing to worry.
Greenish discharge increses in pregnancy and if not associated with itching or bad odor then there is no need to take it seriously.
Just ask her to wear cotton based underwear and avoid tight clothes like jeans for long intervals.
Also she should increase her water intake.
These simple measures will help in avoiding infection in future.
Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Jain (4 minutes later)

Thank you so much for your help and advise.
Take Care.

Regards

Answered by Dr. Manisha Jain (1 minute later)

Brief Answer:
welcome

Detailed Answer:
Most welcome dear.
In case you have any questions in future you can contact me directly on http://bit.ly/drmanishajain

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar