Vaginitis is inflammation of the vagina and the area around the vagina (vulva). 

Vaginitis is often caused by an infection, but it may also be caused by a reaction to vaginal products such as soap, bath oils, spermicidal jelly, or douches. Vaginitis may cause symptoms such as vaginal itching, pain, or discharge. A vaginal smear (sometimes called a wet mount) is done to help determine the cause of vaginitis.

Infections that can cause vaginitis are common and include:

• Yeast infection. A vaginal yeast infection is usually caused by a type of yeast called Candida albicans. A yeast infection is also called a candida infection, or candidiasis. A vaginal yeast infection often causes a white, lumpy discharge that looks similar to cottage cheese, itching, and pain with sexual intercourse. A yeast infection is not considered a sexually transmitted disease (STD).
• Trichomoniasis. Trichomoniasis is a disease caused by a parasite (Trichomonas vaginalis). It is sometimes called Trichomonas infection, Trichomonal infection, or trich (pronounced "trick"). Trichomoniasis can produce discharge from the vagina that is yellowish-green, foamy, and foul-smelling. Pain with sexual intercourse or urination and abdominal pain may also occur. Trichomoniasis is usually spread by sexual contact with an infected person. Therefore, it is considered a sexually transmitted disease (STD).
• Bacterial vaginosis (BV). Bacterial vaginosis develops when some types of bacteria that may live in the vagina in low numbers (mainly Gardnerella vaginalis) become more common than the normal vaginal bacteria (lactobacillus). The most distinctive symptom of BV is a thick, milky vaginal discharge with a strong fishy odor. However, nearly half of all women with BV have no symptoms. BV is not usually considered a sexually transmitted disease (STD). 
• Other sexually transmitted diseases (STDs). Infections such as chlamydia, genital warts, syphilis, and gonorrhea can also affect the vagina. However, a diagnosis of these diseases usually requires other tests in addition to a vaginal smear. Genital warts may cause abnormal Pap test results.

The vaginal smear may involve the following tests:

• Wet mount. A sample of the vaginal discharge is placed on a glass microscope slide and mixed with a salt solution. The prepared slide is then examined under a microscope for bacteria, yeast cells, trichomoniasis organisms (trichomonads), white blood cells that indicate an infection, or clue cells that indicate bacterial vaginosis (BV).
• KOH slide. A sample of the vaginal discharge is placed on a slide and mixed with a solution of potassium hydroxide (KOH). The KOH destroys bacteria and cells from the vagina, leaving yeast hyphae and spores (if present) that indicate a yeast infection.
• Vaginal pH. The normal vaginal pH is 3.8 to 4.5. Bacterial vaginosis (BV) and trichomoniasis often cause a vaginal pH greater than 4.5.
• Whiff test. Several drops of a potassium hydroxide (KOH) solution are added to a sample of the vaginal discharge. A strong fishy odor from the mixture suggests bacterial vaginosis (BV) is present.
• Gram stain. A sample of the vaginal discharge is placed on a microscope slide. A special dye is applied to the slide, causing certain types of bacteria ("Gram-positive" bacteria) to turn a shade of purple while coloring others ("Gram-negative" bacteria) pink. In bacterial vaginosis (BV), Gram-negative bacteria, especially Gardnerella vaginalis, are most common.

The vaginal smear is done on a sample of vaginal discharge.

Vaginal Smear
Results

Discharge
Normal:	No unusual vaginal discharge is present.
Abnormal:	A white, lumpy discharge that looks similar to cottage cheese may indicate a vaginal yeast infection. A greenish, foamy discharge that has a foul odor may indicate trichomoniasis. A thick, milky vaginal discharge with a strong fishy odor may indicate bacterial vaginosis (BV). The presence of many Gardnerella vaginalis bacteria on Gram stain may indicate BV.

Wet mount
Normal:	No yeast hyphae, disease-causing bacteria, trichomoniasis organisms (trichomonads), or clue cells are found on the slide. White blood cells are absent or very low in number.
Abnormal:	High numbers of white blood cells often indicate a vaginal infection. Yeast cells found on the wet mount indicate a vaginal yeast infection. Trichomonads on the wet mount indicate trichomoniasis. The presence of clue cells indicates bacterial vaginosis (BV).

KOH slide
Normal:	No yeast hyphae or spores are found.
Abnormal:	The presence of yeast hyphae or spores indicates a yeast infection.

Vaginal pH
Normal:	Vaginal pH is 3.8 to 4.5.
Abnormal:	Vaginal pH is greater than 4.5.

Whiff test
Normal:	Adding a potassium hydroxide (KOH) solution to a sample of vaginal secretions does not produce a fishy odor.
Abnormal:	A fishy odor produced by the whiff test may indicate bacterial vaginosis (BV).