Inflammatory PAP smears and its microbiological association: A prospective study

Shashikant Adlekha, Tandra Chadha

Abstract


Background: Non specific inflammatory PAP smears are common and cause clinical dilemma in management of patient. Microbiological methods are more accurate method of diagnosis of pathogens of female genital tract. Materials and Methods: A total of 252 PAP smears and vaginal swabs of nonpregnant women referred to the laboratory, constituted the material of the study. Results: Pap smears showed high predictive values, comparable to microbiological testing in detection of pathogens. Apart from inflammatory pattern, a spectrum of diagnosis was given, based on cytological criteria. Majority of the PAP smears in which pathogens were detected, showed significant inflammation. Bacterial vaginosis constitutes the most common cause of vaginal discharge, followed by Trichomoniasis and then Candidiasis in our set up. Pap smears also revealed that 7 out of 252 cases were having various grades of cervical dysplasia. Conclusions: A report of inflammatory changes on the cervical Pap smear cannot be used to reliably predict the presence of a genital tract infection. Combination of PAP smear and simple, cost effective microbiological tests, coupled with primary clinical diagnosis lead to significant improvement in patient management.


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