What is the role of a whiff 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 the whiff test, vaginal discharge is placed on a slide with 10% potassium hydroxide (KOH) solution. A positive test result is the release of an amine (fishy) odor after the addition of KOH to the discharge. The odor is due to the release of amines such as putrescine, cadaverine, histamine, and trimethylamine.

Bacterial vaginosis is associated with an intense amine odor on this test; however, the whiff test is not highly sensitive or specific for diagnosing this condition. A negative whiff test result is 65%-85% sensitive for candidal infection; as many as 30% of symptomatic candidiasis cases show false-negative results. The whiff test may be positive with Trichomonas vaginitis.


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