The emergency department diagnosis of Trichomonas vaginitis

Trichomonas vaginalis is a common cause of vaginitis in emergency department patient populations. While the diagnosis of this condition is usually on the basis of wet-mount microscope slide preparations, other diagnostic technology exists. We studied the accuracy of the traditional wet-mount technique as compared with detection using direct immunofluorescence and culture techniques in ED patients with the presenting complaint of vaginal discharge. Of 157 patients evaluated, the wet-mount technique detected 27 cases of Trichomonas, compared with 35 cases diagnosed by direct immunofluorescence and 52 cases detected by culture. This represents a false-negative rate for the wet-mount technique of 51%; the false-negative rates for direct immunofluorescence and culture technique were 36% and 5%, respectively. Our study suggests that the wet-mount technique is relatively insensitive in the detection of Trichomonas vaginitis.