Lab test interpretation

Clue Cells and Leukocytes in Bacterial Vaginosis

Causes of leukocytosis and clue cells in a vaginal smear. Differential diagnosis of bacterial vaginosis and mixed infections. Learn more.

Another portion of microscopic beauty✨

🔬 Vaginal smear: “Clue cells” + many leukocytes

Usually, in bacterial vaginosis, there are few leukocytes. But if there are many: ⚠ most likely, it’s not pure bacterial vaginosis, but a mixed infection — for example, with trichomonads, chlamydia, or fungi. Another reason: an incorrectly collected smear — if the sample is taken from the cervix or during menstruation, there may be more leukocytes.

📹 The video shows a real example of such a picture under the microscope.

👉 Why are there usually few leukocytes in bacterial vaginosis? Because bacterial vaginosis is not a classic inflammation, but a microflora imbalance, with a predominance of anaerobic bacteria, and it usually proceeds without a pronounced immune response.

🙏 The video and photo were kindly provided by clinical laboratory diagnostics physician Masha Roldugina, Moscow