WET PREP

Code
600.0350
Name
WET PREP
Category
None
Department
Microbiology
Start Date
Expiration Date
Synonyms
Trichomonas; Yeast; Vaginal/Cervical Clue Cells
CPT Codes
87210
Site
Main Lab
Reference Test
ATLAS Test Code

Specimen Information

Type

Swab

Volume

Transport Info

Room Temp

Fasting Required?
False
Patient Instructions

Collect vaginal or cervical secretions with sterile swab.

Reference Range

No yeast, trichomonas, or clue cells seen.

Methodology

Microscopic Examination

Clinical Significance

Establish the presence of Trichomonas vaginalis, bacterial vaginosa, or yeast; detect Trichomonas in the male reservoirs.

The wet mount is a rapid microscopic technique used to examine vaginal, cervical, or skin specimens for the presence of Trichomonas vaginalis, yeast cells, clue cells, and white blood cells (WBC). Microorganisms examined in a living state allow for motility, morphology, and other identifying characteristics to be readily observed. Trichomonas vaginalis is a flagellate and is best recognized by its rapid motility. Yeast cells can be observed as round to oval budding cells (approximately 3-10 µ). Clue cells are vaginal squamous epithelial cells (SEC) covered with numerous small coccobacilli. WBC are seen as spherical cells (15-30 µ) with prominent single or multi-lobed nuclei.Each one of these microorganisms can cause a specific disease or condition. Trichomonas vaginalis causes a common vaginal infection characterized by inflammation with itching and vaginal discharge. Males may have asymptomatic infections or occasionally symptomatic prostatitis or urethritis.Yeasts are considered to be part of the normal flora of the oropharynx and gastrointestinal tract. However, clinical disease may arise in conditions in which there is a modification of the host defenses or suppression of the normal bacterial flora. Some conditions predisposing to yeast infection are: pregnancy, diabetes mellitus, indwelling catheters, chronic debilitating diseases, prolonged therapy with broad-spectrum antibiotics, and AIDS. Involvement of the vaginal and oral mucous membranes is common. Redness, edema, and the presence of soft white patches or coatings of the tonsils, gums, tongue, and vulva/vaginal mucosa are common presentations.“Clue cell” is a term for a vaginal squamous epithelial cell (SEC) that is coated with tiny coccobacilli such that the SEC border is obliterated or appears shaggy and may be dense enough to partially obscure the nucleus. The presence of clue cells in vaginal secretions is one of four findings used for the diagnosis of bacterial vaginosis (BV). Other laboratory sign include a vaginal pH greater than 4.5, a positive whiff test (fishy order on addition of 10% KOH to vaginal secretions), and abnormal vaginal flora (absence of lactobacilli and increase of Gardnerella and anaerobes). Bacterial vaginosa is characterized by an increase in vaginal discharge, a shift in vaginal pH, a change in the vaginal microbial flora and the observation of clue cells. The wet mount may also be used to identify spermatozoa, particularly in cases of sexual assault. Spermatozoa have oval heads approximately 3.0 to 5.0 µm long and thin, thread-like tails about 40-60 µm in length.

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