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Endocervical gram stain

Endocervical gram stain is a method of identifying bacteria on tissue from the cervix using a special series of stains.

Alternative Names

Gram stain of cervix

How the test is performed

This test requires a sample of tissue from the lining of the cervical canal (the opening to the uterus).

You lie on your back with your feet in stirrups. The health care provider with insert an instrument called a speculum into the vagina. This instrument is used during regular female pelvic exams. It is used to stretch open the vagina in order to better view certain pelvic structures.

After the cervix is cleaned, a dry, sterile swab is inserted through the speculum and to the cervical canal and gently turned. It may be left in place for a few seconds to absorb as many germs as possible.

The swab is removed and sent to a laboratory, where it will be smeared on a slide. A series of stains called a gram stain is applied to the sample. A laboratory technician looks at the stained smear under the microscope for the presence of bacteria. The color, size, and shape of the cells help identify the type of bacteria.

How to prepare for the test

Do not douche for 24 hours before the procedure.

How the test will feel

You may feel minor discomfort during specimen collection. This procedure feels very much like a routine Pap smear .

Why the test is performed

This test is used to detect and identify abnormal bacteria in the cervix area. If you develop signs of an infection or think that you have a sexually transmitted infection (such as gonorrhea), this test can help confirm the diagnosis. It can also identify the germ that is causing the infection.

This test is rarely done because it has been replaced with more accurate ones.

Normal Values

A normal result means no abnormal bacteria are seen in the sample.

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

  • Bacterial vaginosis
  • Chlamydia
  • Gonorrhea
  • Yeast infection

The test may also be performed for gonococcal arthritis , to determine the site of the initial infection.

What the risks are

There is virtually no risk.

Special considerations

If you have gonorrhea or another sexually transmitted infection, it is very important that all of your sexual partners also receive treatment, even if they have no symptoms.

References

Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6thed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 23. 

Cohen MS. Approach to the patient with a sexually transmitted disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 293.

Workowski KA, Berman S; Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010 Dec 17;59(RR-12):1-110.

Updated: 8/15/2012

Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


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