CYTOLOGIC DIAGNOSIS OF CHLAMYDIA IN CERVICOVAGINAL SECRETIONS - USE OF A PAPANICOLAOU STAIN MODIFICATION WITH BUFFERED WRIGHT SOLUTION

OBJECTIVE: To carry out a prospective study on 1,569 females to evalua te the diagnostic utility of adding buffered Wright solution to Papani colaou stain for observing cytoplasmic inclusions in cervicovaginal cy tology. STUDY DESIGN: Group A had multivacuolated cells and group B, g ranules (not in a vacuole) in the cytoplasm of low-intermediate epithe lial or parabasal cells. There were 7 patients in group A and 16 in gr oup B. Two duplicate plates of cervicovaginal secretions were obtained from each patient before and after treatment; one was stained with Pa panicolaou 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. RESULTS: In group A, six patients had cytoplasmic inclusions with the variant stain, an d two had cytoyplasmic inclusions with Papanicolaou stain. The binomia l test revealed that probably six of the seven patients had infections with Chlamydia (P = .372) and that in 100% of cases, the variant stai n showed cytoplasmic inclusions, while Papanicolaou stain was observed in 33% of cases. These findings were morophologically and statistical ly proven (P = .124) on control slides with posttreatment absence of m ultivacuolated cells. CONCLUSION: In relation to the selection criteri a for B group, the intracytoplasmic granules found in parabasal and lo w intermediate cells had no relation to Chlamydia. The study demonstra ted the superiority of our variant of Papanicolaou stain for cervicova ginal Chlamydia diagnosis.