Cytologic diagnosis of Chlamydia in cervicovaginal secretions. Use of a Papanicolaou stain modification with buffered...

To carry out a prospective study on 1,569 females to evaluate the diagnostic utility of adding buffered Wright solution to Papanicolaou stain for observing cytoplasmic inclusions in cervicovaginal cytology.

Group A had multivacuolated cells and group B, granules (not in a vacuole) in the cytoplasm of low-intermediate epithelial or parabasal cells. There were 7 patients in group A and 16 in group B. Two duplicate plates of cervicovaginal secretions were obtained from each patient before and after treatment; one was stained with Papanicolaou stain and the other with our variant. The trial of therapy consisted of doxycycline (effectiveness for statistical analysis = 0.9) in oral doses of 100 mg every 12 hours for 7 days; 7 days after the beginning of treatment, check samples were obtained.

In group A, six patients had cytoplasmic inclusions with the variant stain, and two had cytoplasmic inclusions with Papanicolaou stain. The binomial test revealed that probably six of the seven patients had infections with Chlamydia (P = .372) and that in 100% of cases, the variant stain showed cytoplasmic inclusions, while Papanicolaou stain was observed in 33% of cases. These findings were morphologically and statistically proven (P = .124) on control slides with posttreatment absence of multivacuolated cells.

In relation to the selection criteria for B group, the intracytoplasmic granules found in parabasal and low intermediate cells had no relation to Chlamydia. The study demonstrated the superiority of our variant of Papanicolaou stain for cervicovaginal Chlamydia diagnosis.