Bacterial vaginosis

Bacterial vaginosis is a polymicrobial clinical syndrome characterized by a partial reduction or disappearance of lactobacilli and, conversely, an overgrowth of aerobic and anaerobic bacteria in the vagina. These are bacteria that are commonly found here (Gardnerella vaginalis, Prevotella, Mobiluncus). It is a non-inflammatory disease and is the most common cause of vaginal fluorosis (discharge) in sexually active women.

Clinical presentation
It is manifested by a grey-white vaginal discharge with a characteristic "fishy smell". This may appear only after the addition of 10% KOH.

Diagnosis
If suspected, measure vaginal fluoride pH, which is > 4.5. In the native microscopic specimen, we find numerous epithelial cells and a granular appearance of the cytoplasm for the presence of a large number of bacteria.

Differential diagnosis
We distinguish bacterial vaginosis from vaginitis.

Therapy
Metronidazole 2 × 500 mg/day for 7 days, or metronidazole gel for 5 days, or clindamycin 2% cream for 7 days.

Course and prognosis
Vaginosis left untreated increases the risk of sexually transmitted infections, premature amniotic fluid drainage and childbirth.

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