Vaginal thrush, bacterial vaginosis and trichomonasvaginalis can detect by testing the vaginal discharge through high vaginal swab procedure in obstetrics and gynecology.

It should be done in aseptic conditions, by a healthcare professional who uses a speculum to look at the cervix and vagina. The swab has to be insert the top of the vagina and it is rotated around to acquire a sample of the discharge and subsequently the speculum is removed and the sample sent for microscopy, culture and sensitivity.

When to Send high vaginal swab:        

• postnatal     
• pre& post termination of pregnancy
• pre&post operativegynae surgery
• persistent or recurrent (≥ 4 episodes/year) symptoms
• symptoms not characteristic of candida or bacterial vaginosis
• vaginitis without discharge
• Possible STI           
• Suspected PID
• Vaginal infections might be a cause for pain and discomfort.

The following symptoms should be a reason to see a doctor:

• unusual vaginal discharge
• vaginal discharge that has a strong odor
• irritation and swelling of the vagina and vulva
• pain and burning sensations while urinating

Vaginal infections and their specific symptoms :

Yeast infections

Vaginal yeast infections caused by fungus called Candida, typically Candida albicans.Candidaspecies penetrate the mucosal lining of the vagina, resulting in an inflammatory response.

Symptoms

• Irritation, itching, and burning in and around the vagina
• Thick, sticky, white discharge
• Swelling and flushing around the vulva and vagina.

Bacterial infections

Bacterial vaginosis

Bacterial vaginosisoccurs due to overgrowth of the bacteria that are naturally present in the vagina. This is because of a decreaseTrusted Source in the bacteria lactobacilli in the vagina.

Symptoms

Not every person with bacterial vaginosis will experience symptoms.

If symptoms are present, a person can expect:

• thin gray or white discharge
• a fishy-smelling odor from the vagina
• a burning sensation while urinating
• pain during sexual intercourse
• itching of the vulva

Chlamydia and gonorrhea

Other bacterial infections, such as chlamydia and gonorrhea, are sexually transmitted infections.

Symptoms

 Most of the people do not have any symptoms of chlamydia, and if they do appear, it might not be for several weeks.

However, symptoms may include:

• white, green, or yellow discharge
• bleeding
• a burning sensation during urination
• pain during sexual intercourse

More than 50% of females will not experience any symptoms of gonorrhea.

Symptoms of gonorrhea include:

• vaginal discharge that may be green, white, or yellow
• pelvic pain
• a burning sensation while urinating
• swelling and pain of the labia

Viral infections

Some viral vaginal infections include herpes simplex virus type 2 (herpes) and the human papillomavirus (genital warts).

A person can be affected by these viruses through sexual intercourse or by coming into skin-to-skin contact with a person who has the infection.

Genital herpes

Symptoms of genital herpes include:

• painful ulcers or sores on the genitals
• burning or pain while urinating
• swelling of lymph nodes
• swelling of the vulva
• fever and headaches

Genital warts

Symptoms of genital warts include:

• warts, either separate or in clusters, around and inside the vagina and anus
• warts that may bleed
• itching, flushing, or discomfort

Trichomoniasis

Trichomoniasis, or trich, is a very common STI. This occurs due to a protozoan parasite called Trichomonasvaginalis.

Symptoms

Nearly 70% of people do not present with signs or symptoms. Some people begin to show symptoms within 5–28 days, while others may not develop symptoms until much later.

If symptoms are present, they may include:

• itchy, sore, flushed, or burning genitals
• a change in vaginal discharge, such as:
  • an increase in volume
  • a change in color to clear, yellow, or green
  • the production of thin discharge
• discomfort during urination

Atrophic vaginitis is a vaginal disorder that usually happens after menopause. When estrogen levels fall, the vaginal walls can become thin, dry, and inflamed. This can be uncomfortable.

Noninfectious vaginitis

Noninfectious vaginitis typically occurs due to irritants. Certain things that come into contact with the vagina may cause an allergic reaction.

• sperm fluid
• spermicides
• latex condoms
• fragrances or cosmetics
• lubricants
• feminine hygiene products
• bubble baths and other soaps with fragrances
• sanitary pads
• other personal care products
• nickel plated objects
• douches that people do not dilute correctly
• close fitting underwear and lingerie

Symptoms

• swelling and irritation of the vagina and vulva
• flushing of the vagina and vulva
• pain, burning, and stinging sensations on the vulva

To find out what triggers a reaction, a doctor may order a patch test. During a patch test, they will apply different substances to the skin to determine which ones cause an allergic reaction.

During pregnancy

According to the National Institute of Child Health and Human Development:

• BV may increase the chance of giving birth prematurely.
• Chlamydia can increase the chance of giving birth prematurely and cause eye infections or pneumonia in the infant.
• Gonorrhea can cause pregnancy loss, premature birth, and low birth weight, as well as eye infections and blindness in the infant.
• People with genital herpes may pass this infection to the infant while giving birth.
• Trich can cause preterm birth and a low birth weight.

When to consult a doctor

It is important to see a doctor if a person experiences any symptoms of a vaginal infection or if a sexual partner informs them that they have an STI.

A doctor will investigate the symptoms to diagnose the cause, and they will be able to form a treatment plan.

Diagnosis

To detect the cause of the infection, a doctor may swab the vagina or the skin outside the vagina and send this swab to a laboratory for analysis.

There are multiple tests that a laboratory can perform on these swabs.

• the wet prep, wherein a technician will put the swab into a saline solution and examine it
• gram stain, often for the diagnosis of BV
• cultures, often for the diagnosis of yeast infections
• DNA technologies, often for the diagnosis of bacterial STIs

Prevention

Although vaginas react to possible triggers of allergies and other lifestyle factors in different way.

• avoiding scented sanitary products, vaginal deodorants, and feminine hygiene products

• avoiding bath products,
• laundry products, and toilet papers that have fragrance or color
• not douching
• not wearing damp or tight clothing
• wearing cotton underwear, and changing underwear daily
• washing sex toys and reusable sanitary products according to the instructions
• changing nonreusable sanitary products every 4–8 hours
• wiping front-to-back after using the bathroom, to prevent germs from the anus from coming into contact with the vagina
• if allergic to latex, avoiding latex lubricants and condoms