Descriptive light and electron microscopy of normal and clue-cell-positive discharge

In women with clue-cell-positive discharge (CCPD), light-microscopical examination of the wet mount suggests a preference of bacteria for certain vaginal epithelial cells (VECs). To investigate this further, a light- and electron-microscopical study of patients and healthy controls was performed, with special emphasis on vitality and glycogen content of VECs and bacterial-epithelial cell interaction. Our study did not reveal morphologic differences between VECs of patients and controls. There was, however, a significant decrease in the percentages of vital and glycogen-containing VECs in CCPD (p less than 0.001), probably caused by an overgrowth of (anaerobic) bacteria. In CCPD vaginal bacteria preferably colonize vital VECs. This could account for the relatively low percentage of clue cells in this condition.