Bacterial Vaginosis

Question 1

Bacterial vaginosis

Answer 1

Overgrowth of anaerobic organisms that leads to fall in lactic acid production and subsequent increase in vaginal pH.

Not sexually transmitted, but almost seen exclusively in sexually active women.

Question 2

Clinical features of bacterial vaginosis

Answer 2

• white, thin vaginal discharge
• ‘fishy’ offensive smell
• may be asymptomatic

Question 3

Diagnostic criteria for bacterial vaginosis

Answer 3

• thin, white discharge
• positive whiff test (fishy odour)
• clue cells on microscopy (stippled epithelial cells)
• vaginal pH > 4.5

Question 4

Managing bacterial vaginosis

Answer 4

Asymptomatic:
- No treatment required

Symptomatic:
- Oral metronidazole 5-7 days
- Alternatives include topical metronidazole or topical clindamycin