A Little-Known Vaginitis-Like Picture: Cytolytic Vaginosis

Cytolytic vaginosis (CV) is a condition characterized by an increase in lactobacilli in the vaginal flora, causing complaints of discharge, itching, dyspareunia, and dysuria. Since there are no antimicrobials in the treatment protocols of CV, the diagnostic and therapeutic criteria of which were first defined by Cibley, differential diagnosis of CV from other vaginitis agents will prevent unnecessary use of antimicrobials and recurrent com-plaints. In our study, we aimed to determine the frequency of CV in patients presenting with vaginitis complaints and the diagnostic accuracy of the diagnostic criteria.

In total, 140 women, 103 with vaginitis complaints and 37 without vaginitis complaints, were examined for bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), Trichomonas vaginalis (Tv), and CV. For the diagnosis of CV, vaginal pH ≤ 4.5, the presence of a large number of lactobacilli in Gram staining, the presence of false clue cells, cytolysis in vaginal epithelial cells, leukocyte deficiency or absence, absence of Tv, BV, or VVC were used.

Out of 103 patients, 30 (29.1%) had BV, 20 (19.4%) had VVC, 20 (19.4%) had CV, 5 (4.9%) had BV and VVC, and 4 (3.9%) had Tv. The sensitivity and specificity of the diagnostic criteria were 80% and 99% for epithelial cytolysis, 70% and 99% for false clue cells, 100% and 86% for pH ≤ 4.5, and 100% and 56% for numerous lactobacilli, respectively.

In Turkey and worldwide, CV is not considered in vaginitis cases. In our study, the high rate of 19.4% in vaginitis cases shows the need for comprehensive research on this subject.