training_koh presentation for wet mount training

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  • 7/31/2019 Training_KOH Presentation for Wet Mount Training

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    Reading KOH Wet Preps

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    Reading KOH Wet Preps

    In order to visualize yeast more easily in vaginal fluid,KOH is used to lyse bacteria and epithelial cells leavingonly yeast and their pseudohyphae (long tubularstructures produced by some yeast) present.

    Hairs, threads from material and other artifacts can bepresent in the sample and these can be mistaken forpseudohyphae.

    Not all species of yeast produce pseudohyphae andbudding yeast present in the sample must be used todetermine if a yeast infection is present. Yeast are much

    larger than bacteria and are approximately the size andshape of the nuclei of epithelial cells. Therefore nucleifrom cells released after lysing can be present andmistaken for yeast.

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    Reading KOH Wet Preps

    The following tips can be utilized in order to correctlyidentify pseudohyphae and yeast in a wet prep.1. Pseudohyphae must have yeast budding off of the tubularstructure in order for it to be correctly identified as pseudohyphae. Ifthere are no buds present, it is not pseudohyphae.

    2. In order for yeast not to be mistaken for nuclei of cells, they mustbe budding. This form resembles a larger oval with a smaller ovalattached at one end. Without the bud, the yeast would look like anuclei.

    Example:

    BudPseudohyphae with buds

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    Reading KOH Wet Preps

    Please view the following slides to see

    these tips utilized.

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    Artifacts

    No yeast budding off

    of the structures areobserved. This can

    not be called

    pseudohyphae.

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    ArtifactNote: No budding yeast are observed

    coming off of the structure. The size is too

    large and the shape is not consistent with

    pseudohyphae.

    Pseudohyphae

    Budding yeast

    Note: Please note the size of the

    epithelial cells in relation to the

    actual pseudohyphae and the

    artifact.

    Epithelial cell

    Epithelial cell

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    Pseudohyphae

    Note: All of the

    budding structures

    coming off.

    This structure is more than likely pseudohyphae,

    but if this was by itself in the wet mount, it

    should not be called positive for pseudohyphae

    because there are no buds coming off of it. Epithelial cell

    Epithelial cell

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    Pseudohyphae

    Bud

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    Artifact

    Structure is too large and

    the shape is not

    consistent withpseudohyphae.

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    Pseudohyphae

    Bud

    Bud

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    Artifact

    Pseudohyphae

    Bud

    Bud

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    Artifact

    No budding yeast

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    PseudohyphaeBudding yeast

    EpithelialEpi

    Epithelial

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    EpithelialEpithelial

    Epithelial

    Pseudohyphae

    BudBud

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    Epithelial Cell

    Budding Yeast

    Note: These are probably

    yeast, but cannot be called

    so because they are not

    budding.