What does the presence of numerous epithelial cells on a microscopic examination indicate in the context of excessive vaginal discharge?

From the Guidelines

Epithelial cells ++ on a vaginal film examination is a significant finding that warrants further investigation to determine the underlying cause of excess vaginal discharge, which could be due to infections, hormonal changes, or irritation, as indicated by the presence of clue cells, yeast, or trichomonads in the sample 1. When interpreting the results of a vaginal film examination, it's crucial to consider the clinical context and the patient's symptoms. The presence of epithelial cells ++ suggests an increased shedding of the vaginal lining cells, which can be associated with various conditions, including bacterial vaginosis, yeast infections, trichomoniasis, or non-infectious causes like atrophic vaginitis or allergic reactions. Some key points to consider in the diagnosis and management of excess vaginal discharge with epithelial cells ++ include:

• The importance of performing a thorough speculum examination to visualize the cervix and vaginal walls for discharge and lesions 1
• The use of wet mount preparations to diagnose yeast infection, bacterial vaginosis, or trichomoniasis, and the potential for false-negative results 1
• The value of pH testing to determine the normal vaginal pH, which should be <4.5, and the presence of amines, which can indicate bacterial vaginosis 1
• The need for additional testing, such as culture, nucleic acid probe, or antigen-based rapid testing, to confirm the diagnosis of trichomoniasis or other infections 1
• The importance of consulting with a healthcare provider to determine the exact cause of excess vaginal discharge and to recommend appropriate treatment, which might include antibiotics, antifungals, or hormone therapy 1.

From the Research

Epithelial Cells in Vaginal Discharge

• Epithelial cells are a type of cell that lines the surfaces of the body, including the vagina 2.
• In the context of excess vaginal discharge, the presence of epithelial cells can indicate an immune response to a potential pathogen 3.
• Vaginal epithelial cells play a crucial role in maintaining a healthy vaginal environment by responding to changes in the vaginal microbiome and producing anti-microbial compounds 3.

Role of Epithelial Cells in Defense Mechanisms

• Epithelial cells act as sentinels, recognizing antigens and responding to potential pathogens 2.
• They can produce and release compounds to minimize the negative consequences of an altered microbiome 3.
• Epithelial cells can also bind and release norepinephrine, upregulating their anti-microbial activity in response to external stress 3.

Implications of Epithelial Cells in Vaginal Discharge

• The presence of epithelial cells in vaginal discharge can indicate an underlying infection or imbalance in the vaginal microbiome 3.
• Further testing and evaluation may be necessary to determine the cause of the excess vaginal discharge and the presence of epithelial cells 3.
• Understanding the role of epithelial cells in vaginal discharge can aid in the development of strategies to prevent and treat vaginal infections and maintain a healthy vaginal environment 2, 3.