Establishing the cause of genitourinary symptoms in women in a family practice. Comparison of clinical examination and comprehensive microbiology
A. O. Berg, F. E. Heidrich, S. D. Fihn, J. J. Bergman, R. W. Wood, W. E. Stamm and K. K. Holmes
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.
Effect of Antibiotics on Vulvovaginal Candidiasis: A MetroNet Study
Xu et al.
J Am Board Fam Med 2008;21:261-268.
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Reliability of the Whiff Test in Clinical Practice
Cohrssen et al.
J Am Board Fam Med 2005;18:561-562.
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Antifungal Susceptibilities of Candida Species Causing Vulvovaginitis and Epidemiology of Recurrent Cases
Richter et al.
J. Clin. Microbiol. 2005;43:2155-2162.
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Evaluation of Vaginal Complaints
Anderson et al.
JAMA 2004;291:1368-1379.
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Does This Woman Have an Acute Uncomplicated Urinary Tract Infection?
Bent et al.
JAMA 2002;287:2701-2710.
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Over-the-Counter Antifungal Drug Misuse Associated With Patient-Diagnosed Vulvovaginal Candidiasis
Ferris et al.
Obstet Gynecol 2002;99:419-425.
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Characterisation and selection of a Lactobacillus species to re-colonise the vagina of women with recurrent bacterial vaginosis
McLEAN and ROSENSTEIN
J Med Microbiol 2000;49:543-552.
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Clinical Diagnosis and the Order of Information
Bergus et al.
Med Decis Making 1998;18:412-417.
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Vaginitis
Sobel
NEJM 1997;337:1896-1903.
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