Microbiology

for

REPRODUCTION
 VAGINAL DISCHARGE

What have you brought back for me from the New World?
Sites for taking specimen for vaginal discharge
Normal Vaginal cells
Gardenella vaginalis
 Penyebab terbanyak BV
 Morfologi: Basil
 Bakteri gram (- & +)
 Motilitas (-)
 Fakultatif anaerob
Gardenella vaginalis…..
 Diagnosis : Genital culture, darah , urin
 Klinis : fishy odor vaginal discharge due to ↑ pH
 Pada pewarnaan gram tampak clue cell
Clue Cells
Candidiasis
Candida albicans (85%)
C. stellatoidea, C. tropicalis,
C. krusei, Torulopsis glabrata

‘Sexually-associated disease’

Itchy / thick curdy discharge

Vaginal soreness, vulvar burning,
dyspareunia, dysuria
Yeast (Direct smear)
Yeast (Gram)
Candida albicans pada sekret vagina
Candida albicans
Pertumbuhan Candida albicans
Medium Pertumbuhan Jamur
 SDA (Soboroud Dextrose Agar)
 Patato Dextrose Agar
 Cool Meal Agar
Trichomoniasis
Protozoan : Trichomonas vaginalis

Profuse, offensive,
greenish-yellow,
frothy vaginal
discharge

Vulvar irritation

Some – normal /
minimal
symptoms

Strawberry cervix
Diagnostic guidelines
Trichomoniasis Presumptive Definitive diagnosis
diagnosis

Purulent, frothy Ovoid protozoan Culture for

malodorous with jerky motility trichomonads using
vaginal discharge (sensitivity:60-70%) Feinberg-Whittington
dysuria, vaginal or Trichosel broth
itch media (Baltimore
Biological Lab)
(Most sensitive)

Flagellated
Saline wet mount trichomonad

pH > 4.5 Giemsa stain

Trichomonas vaginalis
Chlamydial cervicitis
Chlamydia trachomatis
Majority asymptomatic
IP unknown

Mucopurulent discharge
with inflamed cervix

Investigations
1. Antigen detection (DIF)

2. Culture
Endocervical endothelium

*High risk of re-infection

Retest 3-4 months after Rx (no later than 12 months)
Chlamydia
Manifestasi klinik :
 Trachoma
 LGV
 Uretritis non gonore
 Cervicitis mukopurulenta
 Toxoplasma gondii
 Protozoa
 Penyebab Toxoplasmosis
 Defenitif host : Kucing
 Reproduksi aseksual : Mamalia
 Self limiting disease but if infection with T. gondii occurs
for the first time during pregnancy, the parasite can cross
the placenta, possibly leading to hydrocephalus or
microcephaly, intracranial calcification, and chorioretinitis,
with the possibility of spontaneous abortion (miscarriage)
or intrauterine death.
Toxoplasma gondii
 WASSALAM….

 TERIMA KASIH