Bacterial vaginosis Flashcards
Pathophysiology?
BV describes an overgrowth of predominately anaerobic organisms whiich leads to a fall in lactic acid producing aerobic lactobacilli, leading to a raised vaginal pH
Common organism involved?
Gardnerella vaginalis
Is this a sexually transmitted disease?
No, but it is seen almost exclusively in sexually active women
Symptoms?
Fishy, thin white homogenous offensive vaginal discharge
What does the vaginal discharge look like?
Skimmed milk
Do all patients get symptoms?
Asymptomatic in 50% of patients
What criteria is used to diagnose BV? How many of the 4 points need to be present to diagnose? What are the 4 points?
Amsel’s criteria. 3 out of 4 points need to be present:
- thin, white homogenous discharge
- clue cells on microscopy
- vaginal pH >4.5
- positive whiff test
How do you perform a whiff test?
Add potassium hydroxide to the vaginal discharge
Treatment and for how long?
Oral metronidazole for 5-7 days
Relapse rate within 3 months?
> 50% within 3 months
BV can increase what pregnancy risks?
Preterm labour, low birth weight, chorioamnionitis and late miscarriage
What drug is used during pregnancy?
Oral metronidazole
What are you looking for on wet mount microscopy?
Clue cells
Causes of overgrowth of anaerobic organisms?
Anything which can change the vaginal environment:
- douching
- new/multiple sex partners
- use of antibiotics (as these can wipe out the aerobic bacteria meaning bacteria like Gardnerella vaginalis can overgrow leading to BV)
