Clinical study
Nonspecific vaginitis: Diagnostic criteria and microbial and epidemiologic associations

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Abstract

Numerous previous studies of nonspecific vaginitis have yielded contradictory results regarding its cause and clinical manifestations, due to a lack of uniform case definition and laboratory methods. We studied 397 consecutive unselected female university students and applied sets of well defined criteria to distinguish nonspecific vaginitis from other forms of vaginitis and from normal findings. Using such criteria, we diagnosed nonspecific vaginitis in up to 25 percent of our study population; asymptomatic disease was recognized in more than 50 percent of those with nonspecific vaginitis. A clinical diagnosis of nonspecific vaginitis, based on simple office procedures, was correlated with both the presence and the concentration of Gardnerella vaginalis (Hemophilus vaginalis) in vaginal discharge, and with characteristic biochemical findings in vaginal discharge. Nonspecific vaginitis was also correlated with a history of sexual activity, a history of previous trichomoniasis, current use of non-barrier contraceptive methods, and, particularly, use of an intrauterine device. G. vaginalis was isolated from 51.3 percent of the total population using a highly selective medium that detected the organism in lower concentration in vaginal discharge than did previously used media. Practical diagnostic criteria for standard clinical use are proposed. Application of such criteria should assist in clinical management of nonspecific vaginitis and in further study of the microbiologic and biochemical correlates and the pathogenesis of this mild but quite prevalent disease.

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  • Cited by (0)

    This study was supported by National Institutes of Health Program Project grant A1 12191, and the Division of Hospitals and Clinics, Bureau of Medical Services, PHS Project grant SEA 80-6-72.

    1

    From the Departments of Epidemiology and Pathobiology, School of Public Health and Community Medicine, and the Departments of Medicine and Obstetrics and Gynecology, School of Medicine, University of Washington, Seattle, Washington.

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