While it is often possible to correctly guess the cause of a vaginal discharge, based on history and/or physical exam, it is sometimes useful to use laboratory skills to confirm a clinical impression.
Use a wooden spatula or cotton-tipped applicator to directly obtain a sample of the discharge. You can also find abundant discharge on the inside curve of the speculum after you remove it.
Put a Tiny Amount of Discharge on a Microscope Slide
Trichomonas is best seen on the Normal Saline slide.
These protozoans are about the same size as a white blood cell (a little smaller than a vaginal epithelial cell), but their violent motion is striking and unmistakable.
Watch a video showing trichomonads
Read more about trichomonads
Normal Vaginal Epithelial Cell
Clue Cell
Bacterial vaginosis (also known as Gardnerella, hemophilus, or non-specific vaginitis) is characterized by the presence of "clue cells" visible at both low and medium power.
These clue cells are vaginal epithelial cells studded with bacteria. It resembles a pancake that has fallen into a bowl of poppy seeds, but on a microscopic level.
A normal vaginal epithelial cell is clear, with recognizable contents, and sharp, distinct cell borders.
A clue cell appears smudged, with indistinct contents and fuzzy, poorly defined borders.
Watch a video showing a normal vaginal epithelial cell
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Operational Obstetrics
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