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These images are from the original published atlas:
Tenover, F. C., and J. V. Hirschmann. 1990. Interpretation of
Gram stains and other common microbiologic slide preparations.
The UpJohn Company, Kalamazoo, Mich. Permission granted to the
ASM MicrobeLibrary by Pfizer Inc.
This atlas was written to help clinicians,
microbiologists, and laboratory personnel identify organisms
in infected materials stained by techniques commonly used in
most clinical laboratories. Please refer to the atlas'
main page for more information and a guide to all of the
images.
Gram stains and wet mounts are useful
in detecting potential pathogens in vaginal discharges. The
most common forms of vulvovaginitis are bacterial vaginosis
and infections with Trichomonas vaginalis or Candida
albicans.
Slide 1. Normal vaginal secretions
This
specimen of vaginal fluid contains epithelial cells and many
gram-positive bacilli that are Lactobacillus species, a
major part of the normal vaginal flora. The lack of
neutrophils and the presence of normal epithelial cells
suggest that inflammation is absent.
Slide 2. Bacterial vaginosis
This epithelial cell is a
“clue cell” to which large numbers of Gardnerella vaginalis
adhere. The presence of clue cells is an important
criterion in diagnosing bacterial vaginosis, apparently a
synergistic infection involving G. vaginalis and
anaerobic bacteria. Gardnerella vaginalis frequently
stains gram-variable, as does Mobiluncus curtisii, an
anaerobic bacterium often associated with bacterial vaginosis
and visible here as gram-positive curved rods.
Slide. 3. Bacterial vaginosis
Several curved
gram-negative bacilli are on and near a vaginal epithelial
cell to which small gram-positive bacilli also adhere. The
gram-negative rods are Mobiluncus mulieris, bacteria
often present in the secretions of patients with bacterial
vaginosis.
Slide 4. Trichomonas vaginalis
This Gram-stained
specimen shows a large oval organism with an axostyle, which
is a supporting rod running through the body of a trichomonad
and protruding posteriorly. Trichomonas vaginalis, a
protozoan that causes vaginitis, is usually more easily
detected on a wet mount than on a Gram stain.
Slide 5. Trichomonas vaginalis (wet prep)
In this
wet mount, a specimen of discharge was mixed with a drop of
0.9% NaCl and viewed under a coverslip. Several oval organisms
with flagella are visible. Trichomonads are often larger than
neutrophils (white blood cells) and, on a wet mount, often
move with a jerky motion across the microscopic field.
Slide 6. Candida albicans
Wet mounts as well as
Gram stains can be used to detect yeasts such as Candida
albicans, shown here with budding pseudohyphae.
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