1. Conjunctival Discharge

2. Conjunctivitis Inflammation Erythema Several causes: Bacterial Viral
Allergic
Chemical

3. Conjunctivitis - Discharge
Discharge Cause
Purulent Bacteria
Clear Viral
White, stringy mucous Allergies

4. Bacterial conjunctivitis
Purulent discharge
Conjunctival hyperemia

5. Viral Conjunctivitis Adenovirus Systemic viral infections Painful
Herpetic
Discordant lack of pain
Diffuse redness, watery discharge

6. Aim of the test
An etiological diagnosis of bacterial conjunctivitis by aerobic cultivation with identification and susceptibility test of the isolated bacteria .
Types of specimen
Discharge from the eye's.

7. Pathogen and commensals

8. Specimen collection
Pull down the lower eyelid so that the lower conjunctival fornix is exposed.
Swab the fornix without touching the rim of the eyelid with the sterile cotton swab.
Place the swab immediately in a bacterial transport medium or, the specimen is brought to the laboratory immediately, in a sterile test tube with 0.5 mL of buffered saline (pH 7).
Take Sufficient amount on the swab
Time relapse before processing the sample
Eye specimen should be processed immediately because tears contains lysosomes which may kill the organism.

11. Ear Discharge

12. Aim of the test
Aetiological diagnosis of otitis external or otitis media by aerobic and anaerobic culture with identification and susceptibility test of the isolated organism (s).
Types of specimen
Pus from the external or middle ear.

13. Pathogen and commensals

14. Specimen collection
Collect a specimen of the discharge on a thin, sterile cotton wool or Dacron swab.
Place the swab in a container with the transport medium, breaking off the swab stick to allow the stopper to be replaced tightly.
Label the specimen and send it to the laboratory.
Time relapse before processing the sample not more than 2 hours

16. Vaginal Discharge

17. Terminology
Vaginitis : significant inflammatory response in vaginal wall. Accompanied by high number of leukocytes in vaginal fluid. Found with candida and trichomonas infections.
Vaginosis : minimal inflammatory response with few leukocytes in vaginal wall. Associated with increase in bacterial concentrations.
Leukorrhoea : a non-infective, non-bloodstained physiological vaginal discharge.

18. Clinical approach Physical Exam : Diagnostic Tools:
Appearance of discharge.
Erythema and edema of vaginal mucosa.
pH levels.
Diagnostic Tools:
Wet mount: microscopic examination of discharge
KOH test: dissolves cellular debris leaving pseudohyphae of candida.
Whiff test: Fishy odor of BV
Culture.

19. Common Causes Normal discharge (30%) Bacterial Vaginosis (23-50%)
Candida Vulvovaginitis (20-25%)
Trichomonas vaginitis (5-15%)
Mixed infection or Sexually Transmitted Disease (20%)

20. Aim of the test
Isolate and identify potentially aerobic pathogenic organisms including
Gardnerella vaginalis and group B Streptococcus; establish the diagnosis of gonorrhea, medical/legal cases.

21. Types of specimen
Swab of vagina, cervix, discharge, aspirated endocervical, endometrial, prostatic fluid, or urethral discharge.
Use swab to inoculate Jembec for transport to the laboratory and recovery of Neisseria gonorrhoeae; swab
should also be sent in transport device.

22. Pathogen and commensals

23. Specimen processing