Enumeration of clue cells in rehydrated air-dried vaginal wet smears for the diagnosis of bacterial vaginosis

Abstract

Among 235 women attending an outpatient clinic, the diagnosis of bacterial vaginosis was made using three of the following four criteria: typical discharge, pH more than 4.5, positive amine sniff test, and clue cells in a wet smear. These findings were correlated with the finding of clue cells in air-dried wet smears rehydrated more than 1 month after the visit. The rehydrated specimens had the same microscopic appearance as a nonpreserved wet smear. The demonstration of clue cells in the rehydrated smears correlated with the composite diagnosis of bacterial vaginosis with a sensitivity of 96% and specificity of 98%. In a busy multi-physician setting, the scoring of clue cells in stored and rehydrated smears can be used to obtain consistent readings for wet-smear diagnostics, thus simplifying teaching and increasing the utility of wet smears in clinical research.