1st order laboratory parameters – obligatory laboratory tests.
- Amine test (Whiff test) – by sprinkling the vaginal secretion (vaginal fluid) with a 10% potassium hydroxide solution typical fishy odor (= amine colpitis).
- Measurement of the pH of the vaginal secretion (vaginal secretion) [suspicious if pH of the vagina > 4.5].
- Phase contrast microscopy of vaginal secretion – live, unstained cells appear extremely low contrast in the normal bright field microscope, these are well visualized by the phase contrast method[microscopic detection of “clue cells” in at least 20% of epithelial cells].
Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification.
- Bacteriological/mycological/virological culture – cultivation of bacteria/fungi from the vulva (entirety of external primary genital organs) and/or from vaginal secretions (vaginal secretions) in recurrent colpitids (recurrent vaginal infections).
- Bacteria: Chlamydia trachomatis (lymphogranuloma venereum, cervicitis (cervicitis), adnexitis (ovarian inflammation)), Neisseria gonorrhoeae (gonorrhea, gonorrhea), Treponema pallidum (syphilis, lues), Ureaplasma urealyticum (cervicitis, adnexitis, urethritis (urethritis)) and others.
- Fungi: Candida albicans and other Candida species: (urethritis, vaginal mycosis (vaginal fungus), vaginal candidiasis).
- Viruses: herpes viruses (cultivation from vesicle contents) method of choice.
- Virus detection
- Molecular genetic diagnostics (DNA or PCR): HIV (AIDS), herpes simplex virus type 1/2 (genital herpes), human papilloma virus (HPV; condylomata acuminata).
- Other detection: herpes viruses:
- From vesicle smear applied to a microscope slide. Determination of the virus type by fluorescence test using type-specific immune sera if necessary direct antigen test (fluorescence test).
- Histologically after biopsy (fine tissue examination after a tissue biopsy).
- Colposcopic (see below colposcopy): dabbing with 3% acetic acid (affected skin areas turn white).
- Cytological smear (smear as part of the screening examination for early detection of cervical cancer).
- Parasite detection (microscopic): crabs (pediculosis pubis), mites, oxyurans (pinworms), scabies (scabies), Trichomonas vaginalis (trichomoniasis).
- Antibodies against Chlamydia trachomatis, HSV type 1 u. 2, HIV, Treponema pallidum (TPHA, VDRL etc.) – due toexclusion of sexually transmitted infections.
- Biopsy for histological examination
- Cytology
The diagnosis of bacterial vaginosis is considered confirmed when three of the following findings have been obtained (Amsel criteria):
- Thin fluorine (discharge).
- Fluorine smelling of amine – especially after alkalization.
- Detection of so-called Clue Cells in the vaginal smear (vaginal swab).
- PH value of the vagina (vagina) > 4.5
