Automatic identification of fungi in microscopic leucorrhea images.

Identifying fungi in microscopic leucorrhea images provides important information for evaluating gynecological diseases. Subjective judgment and fatigue can greatly affect recognition accuracy. This paper proposes an automatic identification system to detect fungi in leucorrhea images that incorporates a convolutional neural network, the histogram of oriented gradients algorithm, and a binary support vector machine. In experiments, the detection rate of the positive samples was as high as 99.8%. The experimental results demonstrate the effectiveness of the proposed method and its potential as a primary software component of a completely automated system.

Leucorreas líquidas y cremosas: diferencias clínicas y microbiológicas (estudio prospectivo de 1 año) / A 1-year prospective study of liquid and creamy leukorrheas: clinical and microbiological differences

Objetivo Estudio prospectivo de 1 año sobre leucorreas, líquidas y cremosas, diferenciando sus características clínicas y microbiológicas. Diseño y método Se clasifican las leucorreas en líquidas y cremosas según su aspecto y características en la exploración vaginal con espéculo. Se toman muestras para citología cervicovaginal y muestra con escobillón a medio de transporte para cultivo microbiológico. Resultados La edad media de las mujeres fue 30 años (rango, 16-62 años). Eran nuligestas el 50%. En 60% las leucorreas se dieron en la 2.a fase del ciclo. Mayor frecuencia de casos en primavera (meses III y IV). En 50% las leucorreas eran blancas y en 25% amarillas. Había prurito en 25%. Estaban depiladas en 25%. No usaban contracepción en 60%. Eran extranjeras el 23%.La citología fue positiva en 35%. El diagnóstico más frecuente fue la vaginosis bacteriana en 17%.El cultivo fue negativo en 88%. En los cultivos positivos, los gérmenes más frecuentemente encontrados fueron: Gardnerella vaginalis en 37% y Candida albicans en 31%.ConclusionesLas leucorreas líquidas son más fisiológicas, tienen cultivo negativo en 50%. Los gérmenes más frecuentemente encontrados fueron: Gardnerella vaginalis y Candida albicans en 17,30%, respectivamente. Las leucorreas cremosas son más patológicas, con cultivo positivo en 61,42%. Los gérmenes más frecuentemente encontrados fueron: Gardnerella vaginalis en 22,85%, Candida spp. en 21,25% y Candida albicans en 14,28% (AU)

Objective We performed a prospective 1-year study to identify the clinical and microbiological characteristics of liquid and creamy leukorrheas. Design and method We classified leukorrheas into liquid and creamy, according to their appearance and characteristics in vaginal examination with a speculum. Samples were taken for cervicovaginal cytology. A further sample was taken with a cotton-swab for transfer to a medium for microbiological culture. Results The mean age of the women was 30 years (range, 16-62 years). Fifty percent were nulligravidas. The leukorrheas were found in the second phase of the menstrual cycle in 60% of the women and were more frequent in spring (March and April). The leukorrheas were white in 50% and yellow in 25%. Pruritus was found in 25%. The vulvas were depilated in 25%. Sixty percent of the women used no contraception. Twenty-three percent were foreigners. Cytology was positive in 35%. The most frequent diagnosis was bacterial vaginosis in 17%. Culture was negative in 88%. In positive cultures, the most frequent organisms were Gardnerella vaginalis in 37% and Candida albicans in 31%.ConclusionsLiquid leukorrheas were more physiologic as cultures were negative in 50%. The most frequent organisms were G. vaginalis and C. albicans, each being found in 17.30% of patients. Creamy leukorrheas were more pathologic, with positive culture in 61.42%. The most frequent organisms were G. vaginalis in 22.85%, Candida spp in 21.25%, and C. albicans in 14.28% (AU)

[Causation and treatment of infectious leucorrhoea at the Cocody University Hospital (Abidjan, Côte d'Ivoire)]. / Etiologie et prise en charge thérapeutique des leucorrhées infectieuses au CHU de Cocody (Abidjan, Côte d'Ivoire).

OBJECTIVES: to determine the frequency of different bacteria causing infectious leucorrhoea and to calculate the percentage of cures after standard treatment. PATIENTS AND METHODS: This 7-month prospective descriptive study took place from October 2003 through April 2004 in the gynaecology department of Cocody University Hospital and in the department of sexually-transmitted infections of the Pasteur Institute of Côte d'Ivoire. After identification of the organism causing each case of leucorrhoea, we prescribed treatment according to a standard protocol. Vaginal samples were taken after treatment and tested to assess its success. RESULTS: The most frequent bacteria discovered, in descending order, were: Gardnerella vaginalis (47%), Candida albicans (29.4%), Chlamydia trachomatis (13.7%), Trichomonas vaginalis (6.9%), and Neisseria gonorrhoeae (2.9%). The overall cure rate was 87%. Treatment failure was most common for C. trachomatis (8 of 14 cases, 57.1%), N. gonorrhoeae (1 of 3 cases) and T. vaginalis (2 of 7 cases, 28.6%). Treatment was 100% effective for G. vaginalis and C. albicans. CONCLUSION: The fight against sexually-transmitted infections should be intensified, and patients and physicians cautioned about use of doubtful generic drugs.

[Sexual transmissible diseases and "returning leukorrhea"]. / Maladies sexuellement transmissibles et les "leucorrhées de la rentrée".

White discharges and sexual transmissive diseases are now increasing. Confronted to this symptom, the general practician can easily diagnose and treat his patient. Therefore he must keep in his mind that behind this common symptom, a much more serious disease can be hidden.

Quiste vaginal de inclusión gigante / Giant vaginal inclusion cyst

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[The microbial findings in leukorrhea]. / Mikrobni nakhodki pri genitalen fluor.

During two periods /1984/86 and 1998/01.00/ were studied microbial findings from vaginal specimens of women in reproductive age /16-48/. Candida spp. was isolated most frequently /17.3% to 21.5%/. BV was increased from 4.6% to 13.1%. T. vaginalis was decreased from 8.7% to 1.8%, probably as a consequence of metronidazole appliance.

Association of Mycoplasma hominis and Ureaplasma urealyticum with some indicators of nonspecific vaginitis.

The purpose of this study was to determine the isolation rates of Mycoplasma hominis and Ureaplasma urealyticum from three populations of women and also to relate the presence of these microorganisms with some indicators of nonspecific vaginitis. Three hundred vaginal swabs were taken from delivery, pregnant and control (not pregnant) women. Cultures were done in E broth supplemented with arginine or urea. M. hominis was isolated in 5% at delivery, 12% from pregnant and 5% from control women and U. urealyticum was isolated in 21%, 31% and 28% respectively. There was statistical difference in the isolation rate of M. hominis in pregnant women respect to the other groups. Both microorganisms were more frequently isolated in women with acid vaginal pH, amine-like odor in KOH test, clue cells and leucorrhea. M. hominis was isolated in 17% and U. urealyticum in 52% from women with nonspecific vaginitis. M. hominis was isolated in 2% and U. urealyticum in 13% from women without nonspecific vaginitis. Although the presence of clue cells and amine-like odor in KOH test have relationship with Gardnerella vaginalis, these tests could also suggest the presence of these mycoplasmas.

Evaluation of two clinical protocols for the management of women with vaginal discharge in southern Thailand.

OBJECTIVES: (1) To compare the effectiveness of two clinical protocols for the management of vaginal discharge in the situations where no laboratory facilities are available but speculum examination is possible and where basic laboratory facilities are available. (2) To determine clinical and simple laboratory indicators for diagnosis of patients with vaginal discharge in the local setting. DESIGN: Alternate allocation of subjects to one of two management protocols. SUBJECTS: Women presenting to university gynaecology outpatients department with a complaint of vaginal discharge. METHODS: Subjects were alternately allocated management according to one of two protocols: one without (group A) and one with (group B) immediate access to results of basic laboratory tests. Full clinical assessment including speculum examination and microbiological assessment for infection with gonorrhoea, chlamydia, candida, trichomonas, and bacterial vaginosis was performed on all women. Follow up assessment of clinical and microbiological response was performed 1-2 weeks later. RESULTS: At initial assessment, both groups were similar in all respects except that more group B women had inflammation of the vulva. The prevalences of various conditions were: candidiasis 22%, bacterial vaginosis 38%, trichomoniasis 4%, chlamydia 4%, gonorrhoea 0.4%. There was no association between any demographic characteristic and diagnosis of cause of the discharge. Both protocols resulted in clinically and statistically significant improvements for women with candidiasis, bacterial vaginosis, and trichomoniasis. There were no clinically important differences in outcomes between the two protocols. The sensitivities and specificities of various indicators were: curd-like vaginal discharge for candidiasis, 72% and 100%; homogeneous vaginal discharge for bacterial vaginosis or trichomoniasis, 94% and 88%; absent or scanty lactobacilli for bacterial vaginosis, 99% and 68%; > 20% clue cells for bacterial vaginosis, 81% and 99%; visible endocervical mucopus for chlamydia or gonorrhoea, 36% and 86%; microscopic endocervical mucopus for chlamydia or gonorrhoea, 64% and 69%. CONCLUSIONS: Both protocols were equally effective in managing women with abnormal vaginal discharge. Simple clinical indicators for candidiasis, bacterial vaginosis, or trichomonas as in protocol A are sufficiently sensitive and specific for use in situations with no laboratory support. A modification to protocol A could increase detection of bacterial vaginosis at basic health service level. Further work is needed to identify appropriate indicators for infection with chlamydia or gonorrhoea.

A clinicobacteriological study on leucorrhoea.

The pathogens like Trichomonas vaginalis (4.5%), N gonorrhoeae (2.7%) and C albicans (6.7%) were exclusively present in leucorrhoea. The other potential agents with their respective percentages in normal women and cases of leucorrhoea were U urealyticum (21.2% and 50.2%), actinomyces (29.7% and 41.6%), Chlamydia trachomatis (17% and 48.8%), candida-like organisms (CLO) (1.2% and 9.5%) and non-group B streptococci (4.2% and 16.7%). The percentages of urethral syndrome (65.8%), vaginal irritation (63.4%), sore vulva (17%), cervicitis (13.4%), cervical erosion (11%) of the STD clinic were more than those of gynaecological cases. The latter group more often revealed infertility (15.8%) and pelvic inflammatory disease (13.6%). The exclusive isolation rate of N gonorrhoeae (7.3%) and prevalence of G vaginalis (19.5%) and Trichomonas vaginalis (8.5%) in the STD clinic were notable. The cases of gynaecological clinic more commonly showed C albicans (8%) and CLO (13.6%). Significant differences pertaining to U urealyticum (leucorrhoea and inapparent group p < 0.01; leucorrhoea and normal cases p < 0.01), M hominis (leucorrhoea and inapparent group p < 0.05; leucorrhoea and normal cases p < 0.01), Chlamydia trachomatis (leucorrhoea and normal cases p < 0.01) and also actinomyces (leucorrhoea and normal cases p < 0.01; inapparent and normal cases p < 0.05) were recorded. There was conspicuous association of U urealyticum, M hominis, G vaginalis, Chlamydia trachomatis, CLO and actinomyces with leucorrhoea. An almost exclusive presence of Staph aureus, Esch coli and Klebsiella in cases of leucorrhoea appeared meaningful.

Detection of Chlamydia trachomatis by immunofluorescence, papanicolaou and immunoperoxidase in women with leucorrhea

Se realizó la determinación de la incidencia de Chlamydia trachomatis por los métodos de Papanicolaou, inmunofluorescencia e inmunoperoxidasa y su asociación con otras bacterias en 245 mujeres con manifestaciones clínicas de leucorrea, que acudieron a los centros de salud "Gabriel Garzón Cosa" y "Manuel González Rivera" de la Ciudad de México. Se obtuvieron muestras de fondo de saco posterior a la vagina y del endocérvix a partir de los cuales se sembraron diferentes medios de cultivo para realizar el aislamiento e identificación microbiológica de otro tipo de microorganismos y los frotis correspondientes para realizar las técnicas de Gram, inmunofluorescencia directa (IFD) e inmunoperoxidasa, para investigar la presencia de alteraciones citológicas y Chlamydia trachomatis, detectándose este microorganismo en 8 casos (3.3 por ciento) por los tres métodos, de los cuales 4 se detectaron por IFD, 7 por el método citológixco y 6 por inmunoperoxidasa. La infección por Chlamydia se asoció desde el punto de vista citológico con displasia ya sea leve o moderada pero no se encontró una relación directa con un tipo particular de microorganismo como ya ha sido reportado por otros investigadores

Detection of Chlamydia trachomatis by immunofluorescence, papanicolaou and immunoperoxidase in women with leucorrhea.

Bacteriological, Papanicolaou, direct immunofluorescense (DIF) and immunoperoxidase studies were done in 245 samples from women with vaginal discharge and the frequency of Chlamydia trachomatis was investigated. The samples were obtained from two hospitals of the Public Health Services of Mexico City. Samples were taken from the endocervical and posterior fornix areas and streaked in different cultures media for the isolation and microbiological differentiation. Smears were done and stained by Gram, Papanicolaou, DIF and immunoperoxidase techniques and the presence of cytological alterations and Chlamydia trachomatis was investigated. The microorganism was detected in 8 patients by the three methods, only 4 of these were found by DIF, 7 by cytological and 6 by immunoperoxidase techniques. The infection caused by C. trachomatis cytologically was associated with mild or moderate dysplasia but not with some special microorganism.

Vaginal discharge in the adult: a practice guideline.

A practice guideline as a preformatted chart is presented. It is designed to be simple in concept and design, easy to use, parsimonious of data, easily scanned for quality assurance, and to provide clinical and cost-effectiveness prompts. It has supporting medical information for all recommendations that is literature- and experience-based. A patient aftercare instruction sheet is appended. An abbreviated "pocket practice guideline" is also provided. This format is clearly appropriate only for simple, not complex, clinical encounters.

[Leukorrhea in adolescents: an underestimated problem]. / Le leucorree nell'adolescente: un problema sottostimato.

It is by now clear that pediatrician's interest about adolescent's matters is very much increasing. The Authors take into consideration vulvovaginitis, a particular matter which is very frequent during this period of life and describe its most important clinical aspects.

A wet smear criterion for bacterial vaginosis.

OBJECTIVE: To evaluate a simpler criterion for bacterial vaginosis than the recommended criterion of Amsel. DESIGN: Cross-sectional study comparing diagnostic data with a recommended standard. SETTING: Danish general practice. PARTICIPANTS: 595 non-pregnant women aged 15-49 years who were gynaecologically examined, were divided into two groups in accordance with a complaint of vaginal discharge. MAIN OUTCOME MEASURE: The associations of pH > 4.5, homogeneity, amine odour, clue cells, and wet smear assessment of predominance of lactobacilli, Gardnerella vaginalis, motile rods with the criterion of Amsel. RESULTS: The four components of Amsel showed a considerable variation of association. Predominance of GV was more highly associated than several of the components. The association of a wet smear criterion composed of the presence of clue cells in combination with predominance of Gardnerella vaginalis and absence of lactobacilli was superior to other combinations. In the group without a complaint of vaginal discharge, preceding screening with use of a pH-measurement seemed advantageous. CONCLUSION: The wet smear criterion seems suitable for use in general practice. But before a definitive establishment, calculation of the reproducibility of interpretation of this criterion, preferably with a more explicit setting of the components, has to be carried out.

Efecto del sistema killer sobre especies del género candida aisladas de secreción vaginal / Effect of killer system over genus candida species isolated from vaginal secretion

En 348 análisis micológicos de secreción vaginal realizados en el CEREMIC de la Facultad de Ciencias Bioquímicas y Farmacéuticas de la UNR, se determinó un 15 porciento de resultados positivos para diferentes especies del género candida (53 muestras). El objetivo de este trabajo fue: clasificar las levaduras, su sensibilidad al sistema killer SKI, determinar el tipo killer más frecuente y su relación con la reacción inflamatoria. A su vez, estos resultados se cotejaron con los hallados en otros materiales clínicos. Entre las diversas especies de levaduras aisladas, los mayores porcentajes correspondieron a candida albicans (9,48 por ciento), candida tropicalis (1,72 por ciento), candida parapsilosis, candida glabrata (0, 86 por ciento), y en un 0,29 por ciento a otras especies de candida. El tipo killer más frecuente fue 111 (64 por ciento); siendo tambien el más encontrado en materia fecal (67 por ciento) y en piel y faneras (82 por ciento)

First isolation of Campylobacter jejuni from the vaginal discharge of three bitches after abortion in South Africa.

Campylobacter jejuni was isolated in pure culture from the vaginal discharge from three German Shepherd bitches after late-pregnancy abortions. The main clinical sign occurring in the bitches was a profuse and odourless haemorrhagic vaginal discharge.