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Direct wet mount KOH preparations

. Microscopic observation of unfixed wet mounts " of clinical specimens, either stained or unstained can be Useful for the rapid detection ofBacterial,fungal and parasiticOrganisms (based on morphology

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Direct wet mount KOH preparations

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    1. Direct wet mount & KOH preparations

    2. Microscopic observation of unfixed “ wet mounts ” of clinical specimens, either stained or unstained can be Useful for the rapid detection of Bacterial,fungal and parasitic Organisms (based on morphology & motility)

    3. Specimen type : 1-Swabs of the vaginal mucosa & vaginal pool 2- Scraping of suspected skin area

    4. Specimen handling : Swabs should be placed into tubes containing 0.5 ml sterile physiologic saline ( no refrigeration ) -Note : Specimens from the vaginal tract should be tested with PH paper before being placed in saline

    5. Testing procedure : - Prepare KOH & saline slides - Check the KOH slide immediately for a “ fishy “ amine odor - Examine the saline,KOH slides for epithelial cells & any budding yeast or psuedohyphae and quantitate them

    6. Micro. Components in KOH prep. : -Squamous cells - WBC - RBC - Bacteria & parasites - Yeasts & fungi - Clue cells

    7. Quantitation scheme: Rare < 10 org. or cells / slide Occasional < 1 org. or cell /10 hpf 1+(very scanty ) <1 org. or cell / hpf 2+(scanty ) 1-5 org. or cells/hpf 3+( moderate ) 6-30 org. or cells / hpf 4+( profuse ) >30 org. or cells / hpf

    8. Bacterial vaginosis: - Etiology : 1 - Polymicrobial infection 2 – Marked reduction in normally predominant lactobacillus

    9. Bacterial vaginosis : Diagnostic “Amsel criteria ”: A.Vaginal PH >4.7 sensitivity specificity (false positive with menses semen, Trichomona and cervical mucus) B. Clue cells (on >20% of cells ) C. Positive whiff test (Amine test ) D. Discharge characteristics ( thin,non-clumping,gray-white,adherent )

    10. Clue cell : Diagnostic cells which have small gram negative, curved gram negative and gram variable rods covering not only on the surface of the cell but also spread out past the boundaries , obscuring the cytoplasmic margins -Adding KOH : “ lava flow ” appearance

    12. Reference values : WBC 2+ Lactobacilli predominant Clue cells absent Other cells absent (except RBCs during menses ) Other org. Other lactobacilli subgroups, occasional yeast PH <4.5

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