What is the role of a saline wet mount test in the workup of vaginitis?

Updated: Dec 04, 2018
  • Author: Hetal B Gor, MD, FACOG; Chief Editor: Michel E Rivlin, MD  more...
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Answer

In a saline wet mount test, a drop of vaginal discharge is placed on a slide with 1-2 drops of 0.9% isotonic sodium chloride solution and examined under high power (×400).

This test is 60% sensitive and 98% specific for bacterial vaginosis. Clue cells are vaginal epithelial cells covered with many vaginal rods and cocci bacteria, creating a stippled or granular appearance. A decreased number of lactobacilli are observed, and white blood cells (WBCs) are absent.

In patients with vaginal candidiasis, the test reveals hyphae and budding yeast forms. In symptomatic women with trichomoniasis, saline wet mount is 80-90% sensitive for T vaginalis infection. Large numbers of WBCs (>10 per high power field [hpf]) and epithelial cells are observed.


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