Urethral / HVS / endocervical/ vulval / penile etc
Charcoal Swab for HVS / endocervical/ vulval
Minitip swab for urethral specimens
Routine HVS includes culture for streptococci and candida.
Trichomonas investigation and BV testing are not routinely performed and should be indicated when requesting if required.
For an STI screen please send an ECS for gonorrhoea culture.
For chlamydia NAATs testing please send an LVS.
Please include details of treatment.
If vaginal discharge and:
Premenopausal: Please treat empirically in first instance. Send HVS ONLY if not responded to treatment for BOTH candida (itchy, low pH) and Bacterial vaginosis (fishy odour, high pH) as these are the two most likely diagnoses.
Postmenopausal: Please treat empirically in first instance. If bleeding, consider referral to gynae under 2ww. If fails to respond to candida treatment, examine for signs of atrophic vaginitis and cervicitis, and send routine HVS for streptococci and candida culture.
Pregnant: Send HVS if not responded to topical treatment for candida (itchy, low pH) or you think Bacterial vaginosis (fishy odour, high pH) is the most likely diagnosis.
Caution is advised if requesting an STI screen in pregnancy.
Pre-menarche: Vaginal discharge is commonly physiological; swabbing is very rarely indicated and can exacerbate the problem, though Strep vaginitis & thread worm infections may occasionally need excluding.
Try simple measures in the first instance e.g. avoidance of bubble baths, loose fitting cotton clothing, glycosuria dipstix. A perineal swab should be collected in this instance
Cervical swab instructions:
NB Take this swab for diagnosis of gonococcal infection, pelvic infection, post- partum sepsis. If taking Chlamydia swab as well, take bacterial swab before Chlamydia swab
High Vaginal Swab Instructions:
NB Take this swab for diagnosis of Candida, Trichomonas and bacterial vaginosis
Urethral swab instructions:
48-72 hoursSpecimen Labelling Procedure