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Clinicians frequently rely on a history of genitourinary symptoms or the appearance of vaginal discharge to diagnose infections of the vagina and cervix. To determine the diagnostic efficacy of these clinical criteria, we studied 254 unselected abolescent females presenting for reproductive health care. Of the 254 subjects, 105 (41%) had one or more lower genital tract infections (LGTI). Genitourinary symptoms were found to have a sensitivity of 48%, specificity of 78%, positive predictive value (PPV) of 61%, and negative predictive value (NPV) of 68% for the detection of LGTI. When abnormal vaginal discharge was used as an indicator of LGTI, the sensitivity was 65%, specificity 89%, PPV 81%, and NPV 78%. These data suggest that genitourinary symptoms and the appearance of vaginal discharge are inadequate indicators of the presence or absence of lower genital tract infection in adolescent females.
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†Presented in part at the Plenary Session of the Annual Meeting of the Ambulatory Pediatric Association, Washington, D.C., May 9, 1986.
© 1988 Springer-Verlag New York Inc. Published by Elsevier Inc. All rights reserved.