Bacterial Vaginosis

Question 1

What is bacterial vaginosis?

Answer 1

An overgrowth of predominately anaerobic organisms.(e.g. Gardnerella vaginalis)

Question 2

An overgrowth of anaerobic organisms leads to what?

Answer 2

A reduction in aerobic lactobacilli and lactic acid falls.

And thus pH in the vagina rises. (more alkali)

Question 3

Is BV a sexually transmitted infection?

Answer 3

No.

But it is exclusively present in sexually active women.

Question 4

What are Amsel’s criteria for the diagnosis of BV?

(3 of the 4 should be present)

Answer 4

1. Thin, white homogenous discharge
2. Clue cells on microscopy: stippled vaginal epithelial cells
3. Vaginal pH > 4.5
4. Positive whiff test (addition of potassium hydroxide results in fishy odour)

Question 5

What is the managment of BV?

What is the initial cure rate?

What is the 3 month relapse rate?

Answer 5

Metronidazole for 5-7 days.

(70-80% initial cure rate)

BUT

>50% relapse in 3 months

Question 6

What are some alternatives to oral metronidazole?

Answer 6

topical clindamycin or topical metronidazole

Question 7

Describe the features of BV?

Answer 7

• Asymptomatic in 50%
• thin white/grey fishy vaginal discharge