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Comparison of Clinical Examination and Comprehensive Microbiology

Alfred O. Berg, MD, MPH; Fred E. Heidrich, MD, MPH; Stephan D. Fihn, MD, MPH; James J. Bergman, MD; Robert W. Wood, MD; Walter E. Stamm, MD; King K. Holmes, MD, PhD

JAMA. 1984;251(5):620-625.

Abstract
We conducted a prospective study comparing the diagnostic yield of standard clinical examinations and of comprehensive microbiological studies in establishing the etiology of genitourinary (GU) symptoms and the prevalence of GU tract infections in 204 women seen in a university-based family practice. Two thirds were initially seen with GU symptoms and one third were seen for routine examinations. In each case we obtained demographic and historical information, a physical examination, and a variety of laboratory tests, including research procedures not commonly available. Diagnoses considered were urinary tract infection and sterile pyuria; trichomonal, yeast, and nonspecific vaginitis; and GU tract infection with Neisseria gonorrhoeae, Chlamydia trachomatis, or herpes simplex virus. Using strategies commonly employed in practice, we reached a diagnosis in only 34% of symptomatic women, a figure rising to 66% when selected, nonroutine laboratory examinations were added.

(JAMA 1984;251:620-625)

Author Affiliations
From the Departments of Family Medicine (Drs Berg, Heidrich, and Bergman) and Medicine (Drs Fihn, Wood, Stamm, and Holmes), University of Washington, Seattle.

Footnotes
The views expressed herein do not necessarily represent those of the US Army.

Reprint requests to Department of Family Medicine, RF-30, University of Washington, Seattle, WA 98195 (Dr Berg).

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