Is a positive white blood cell esterase in routine vaginal discharge inflammation

Positive white blood cell esterase in routine vaginal discharge examination usually indicates the presence of inflammatory response. The positive leukocyte esterase may be related to bacterial vaginosis, trichomonal vaginitis, vulvovaginal candidiasis and other infectious diseases, and may also be related to non infectious factors such as changes in hormone levels or local irritation. It is recommended to make a comprehensive judgment based on other examination indicators and clinical symptoms, and follow medical advice for targeted treatment. Bacterial vaginosis is one of the common causes of white blood cell esterase positivity, mainly caused by an imbalance of vaginal microbiota, manifested as increased vaginal discharge accompanied by a fishy odor. Treatment can use metronidazole vaginal effervescent tablets or clindamycin phosphate vaginal cream, while avoiding excessive cleaning of the perineum. Trichomonal vaginitis is caused by trichomonas vaginalis infection, and the typical symptom is yellow green foam leucorrhea. Tinidazole tablets or ornidazole capsules can be used for antiparasitic treatment, and sexual partners need simultaneous treatment to prevent cross infection. Vulvar vaginal candidiasis is common in immunocompromised individuals, with white discharge resembling tofu residue and accompanied by obvious itching. Local use of clotrimazole vaginal tablets or miconazole nitrate suppositories may be recommended, and fluconazole capsules may be taken orally if necessary.

Non infectious factors such as decreased estrogen levels during perimenopause may lead to thinning of vaginal mucosa, causing aseptic inflammatory reactions, manifested as weak positive leukocyte esterase but no evidence of pathogen infection. This situation can be improved by locally using estriol cream to improve mucosal condition. Daily use of alkaline detergents, hygiene pads, allergies, and other physical and chemical stimuli can also cause false positive results. After eliminating the causes, re examination indicators can often return to normal. Some healthy women may also experience transient weak positive results during their menstrual cycle due to hormonal fluctuations, and if there are no clinical symptoms, no special treatment is needed.

It is recommended to keep the perineum clean and dry, choose cotton breathable underwear, and change it daily to avoid wearing tight pants that can cause local humid and hot environments. Pay attention to cleanliness before and after sexual activity, and use condoms during treatment to prevent repeated infections. Reducing the intake of spicy and stimulating foods in diet and supplementing yogurt containing lactic acid bacteria in moderation can help maintain the balance of vaginal microbiota. If symptoms such as abnormal increase in vaginal discharge, color change, odor, or itching of the external genitalia occur, it is necessary to promptly re-examine the routine of vaginal discharge and receive standardized treatment.