What is the role of cultures 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

Cultures are of little use in diagnosing bacterial vaginosis and therefore are not generally indicated or recommended in this setting. Cultures with Nickerson or Sabouraud mediums should be performed in refractory or recurrent cases of vaginal candidiasis. Culture using Diamond medium or Trichosel broth is recommended for detection of trichomonads and should be used when infection is suspected but cannot be confirmed by other means. InPouch TV is 90-95% specific and 100% sensitive for culturing T vaginalis.

Gonorrhea usually causes a cervicitis, not a vaginitis, and may be asymptomatic. Symptomatic Neisseria gonorrhoeae infection usually results in a purulent discharge. Obtain cultures of the vagina (in prepubertal patients), cervix (in pubertal and adult patients), oral pharynx, and rectum if gonococcal vulvovaginitis is suspected. Obtain cultures by using a cotton-tipped swab and Thayer-Martin media on chocolate agar, incubated in a carbon dioxide–rich environment (see Pediatrics, Child Sexual Abuse).

Test for chlamydial vulvovaginitis via culture in prepubertal girls and in patients who show signs of abuse or sexual assault. Obtain rectal Chlamydia swabs (see Pediatrics, Child Sexual Abuse).


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