Slide 1. Normal vaginal secretions
This specimen of vaginal fluid contains epithelial cells and many gram-positive bacilli that are Lactobacillus species, a major part of the normal vaginal flora. The lack of neutrophils and the presence of normal epithelial cells suggest that inflammation is absent.

Slide 2. Bacterial vaginosis
This epithelial cell is a “clue cell” to which large numbers of Gardnerella vaginalis adhere. The presence of clue cells is an important criterion in diagnosing bacterial vaginosis, apparently a synergistic infection involving G. vaginalis and anaerobic bacteria. Gardnerella vaginalis frequently stains gram-variable, as does Mobiluncus curtisii, an anaerobic bacterium often associated with bacterial vaginosis and visible here as gram-positive curved rods.

Slide. 3. Bacterial vaginosis
Several curved gram-negative bacilli are on and near a vaginal epithelial cell to which small gram-positive bacilli also adhere. The gram-negative rods are Mobiluncus mulieris, bacteria often present in the secretions of patients with bacterial vaginosis.

Slide 4. Trichomonas vaginalis
This Gram-stained specimen shows a large oval organism with an axostyle, which is a supporting rod running through the body of a trichomonad and protruding posteriorly. Trichomonas vaginalis, a protozoan that causes vaginitis, is usually more easily detected on a wet mount than on a Gram stain.

Slide 5. Trichomonas vaginalis (wet prep)
In this wet mount, a specimen of discharge was mixed with a drop of 0.9% NaCl and viewed under a coverslip. Several oval organisms with flagella are visible. Trichomonads are often larger than neutrophils (white blood cells) and, on a wet mount, often move with a jerky motion across the microscopic field.

Slide 6. Candida albicans
Wet mounts as well as Gram stains can be used to detect yeasts such as Candida albicans, shown here with budding pseudohyphae.