[Question #4467] Elevated White Blood count

27 months ago
I went to the doctor today because i noticed a little foul smell coming from down below and a little white thin discharge. No itching or anything, just thought maybe bv.

After doing a cervical swab my doctor said my white cell count was elevated and was going to send off my swab for std testing. I am in a relationship and was last tested in August, all clean. My doctor said that it could be nothing but wanted to make sure. 

I am freaking out, was i cheated on? Could other things cause a high white blood cell count? She said she didn’t see any yeast or bv. She said maybe soap, but  have using the same stuff (minus my boyfriends soap once, which does have a strong smell). 

Is there other causes then stds? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
Welcome back to the forum. In your other threads with Ms. Warren and Dr. Hook, you describe mention your OCD. However, for this quesiton that may not be relevant. Your symptoms of vaginal discharge and odor sound real, not at all exaggerated; and your doctor clearly agrees you have some sort of vaginal infection.

Vaginal odor and discharge are the most common symptoms of STD in women. However, they are consistent with several STDs, and also with non-STD conditions. I assume that "elevated whie cell count" refers to increased WBC in your vaginal fluid, not a blood count, right? If so, the STD testing indeed makes sense. Possibilities include gonorrhea, chlamydia, trichomonas, and bacterial vaginosis (BV) -- although BV may be less likely, since it usually doesn't cause vaginal WBC and apparently your doctor is aware of BV and didn't see clear evidence of it. OTOH, BV can be difficult to pin down. Also, combinations of problems could cause all this, e.g. WBC from gonorrhea or chlamydia and odor from BV. Yeast seems unlikely:  it doesn't usually cause vaginal odor (contrary to popular opinion) and causes little if any discharge (also contrary to opinion); and most yeast infections are easily diagnosed. I rather strongly doubt that soap or any other kind of allergic or chemical irritation is responsible. You have an infection of somre sort.

Non STD causes? BV is in a gray zone -- associated with sex, but not proved to be due to transmssion of infection from male partners. (But research is ongoing; this could change in the future.) Forgotten tampons can do this. Infrequently, other non-STD bacterial infection could be responsible.

At this point, the main thing is to wait for the results of your STD testing. You might check with your doctor to be sure she the STD testing included trichomonas in addition to gonorrhea and chlamydia. (Make sure trich testing was by PCR, not just looking under a microscope or culture. These miss almost half of all trich, but PCR is highly accurate.) Also it would be interesting to know if your doctor noticed any evidence of cervical inflammation (cervicitis):  "erosion", "ectropion", easy bleeding when passing a swab or doing a pap test, etc.

If any of the tests is positive, you'll have the answer you need. But let's not yet get into when and from whom you were infected. We can address that when the test results are available. I look forward to learning your test results and perhaps more details about your cervix during your exam. In the meantime, I hope these comments are helpful.

HHH, MD
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27 months ago
I’m not sure exactly what she said about my wbc but just said it was higher than usual.

She did examine me but did not mention anything about being inflammed. She only wanted to do the testing due to the white blood cell count. 

She said it was probably cervicitis and that many things can cause that.  She gave me a handout explaining it. 

I have had this before. Sometime last year i visited a doctor for similar symptoms and she said the same thing. Even gave me the same handout. Knowing this, is it possible i am sensitive or something? Knowing that two times i have had higher white blood cell count (or cervicitis) and no stds? 
27 months ago
Hit submit too quickly. what could also cause cervicitis? Other than stds
27 months ago
Thought maybe important to add, the odor is minimal and i really only notice it at night. I have thought maybe i’m paying too much attention to it and noticing. My boyfriend and i had particularly rough sex so was thinking maybe an injury.

I also haven’t noticed much abnormal discharge on my underwear, but after inserting fingers into vagina, i have white/clearish discharge or mucous. Don’t know if thats in line with a sti or just normal behavior. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
Hmm....  now it seems your OCD is playing a role here after all. It sounds like you're paying too much attention, or noticing, normal variations in vaginal moisture, odor, etc. A bit of genital odor from time to time is entirely normal, and the amount of discharge or moisture varies widely both between different women and in any particular woman over time. The clear to white vaginal mucus you describe sounds normal. And mildly elevated WBC in vaginal fluid also is very common and often considered normal.

The information that "it was probably cervicitis" is significant. No cause is known for most cases of cervicitis, it's harmless, and it's so common it can be considered a variation on normal, especially in women taking hormonal contraception. But it could explain symptoms like yours. Anyway, now I have to suggest you discuss this further with your own doctor, i.e. how likely does she believe you have anything wrong at all. And my guess is that your STD tests will be negative and there is nothing to discuss with your partner. But see what your doctor says.
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27 months ago
I will wait for the results and hope for the best. I guess i’m having a hard time figuring out if the odor Is normal or not as i only smell it when i try. And the more i think, the more i think i feel (like i’m trying to feel every sensation.. sound crazy!!)  to make sure i understand, if it is cervicitis, which from what you said sounds relatively normal, that could explain some of the mild symtoms like odor and wbc? Would it make sense that it has happened to me before (cervicitis) for no known reason like an sti, so its happening again without? 

Thank you for your help and I will await my results 
27 months ago
Hello! I wanted to respond with my results. It was all negative! Thank goodness!

However i just noticed some spotting mid cylce (which is pretty common for me) but began to wonder if maybe the tests weren’t accurate. How accurate would a swab test be for chlaymidia/ghonorea 5/6 days after potential exposure? Should i be re-tested?  I don’t want to do that as it is a ritual for my ocd but if my results are not accurate i would consider it. Please let me know your opinon on my test results about a week after.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
Glad to hear the negative results. No need to retest. The gon/chl test picks up all infections after 5 days or so (probalby 2-3 days for gonorrhea, 4-5 for chlamydia). I see no reason to suspect your occasional mid-cycle spotting is related to your recent sexual exposure or to any STD. That said, this is a symptom that should be easily diagnosed by your PCP, or whoever manages your gyn/sexual health care.

I hope the discussion has been helpful. Best wishes.
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