Name
BACTERIAL VAGINOSIS
DESCRIPTION
DETAIL
A POLYMICROBIC SYNERGISTIC INFECTION. CAUSATIVE ORGANISMS : - GARDNERELLA - OTHER ASSOCIATEDBACTERIA ARE LACTOBACILLUS SPECIES & ANAEROBES INCLUDING MOBILUNCUS, BACTEROIDS, PEPTOSTREPTOCOCCUS, FUSOBACTERIUM, VEILLONELLA & EUBACTERIUM SPECIES. MYCOPLASMA HOMINIS, UREAPLASMA UREALYTICUM, STREPTOCOCCUS VIRIDANS -------------------------------------------------------------------------- D.D. : - CANDIDIASIS - CERVICITIS - CHLAMYDIAL GENITOURINARY INFECTION - GONOCOCCAL INFECTION - HERPES SIMPLEX - TRICHOMONIASIS - VAGINITIS* VAGINAL SMEAR FOR MICROSCOPIC EXAMINATION - - Demonstrating 3 of the following 4 criteria is considered necessary to diagnose BV most accurately. * Demonstration of clue cells on a saline smear is the most specific criterion for diagnosing BV. Clue cells are vaginal epithelial cells that have bacteria adherent to their surfaces. The edges of the squamous epithelial cells, which normally have a sharply defined cell border, become studded with bacteria. The epithelial cells appear to be peppered with coccobacilli. * A pH greater than 4.5 indicates infection, and pH may be elevated in up to 90% of patients with BV. * Characteristic discharge appearance is thin, gray, and homogeneous. * The whiff test may be positive in up to 70% of BV patients. This test is performed by placing a drop of 10% KOH on the speculum after the vaginal examination or mixing vaginal fluid with a drop of KOH on a microscope slide. The KOH, by virtue of its alkaline properties, causes the release of volatile amines from the vaginal fluid. The amines are products of anaerobic bacterial metabolism * VAGINAL SMEAR EXAM FOR BACTERIAL FLORA- NORMAL FLORA IS PREDOMINANTLY LACTOBACILLI * ROUTINE VAGINAL CULTURE - NO USE SINCE IT IS POLYMICROBIAL INFECTION
TYPENOTES
Medical Care: Antibiotics are the mainstay of therapy for BV. Asymptomatic women with G vaginalis colonization do not need treatment. Studies of topically applied and orally administered yogurt/lactobacilli preparations, which are used to help reestablish the lactobacilli population in the vagina, have demonstrated inconsistent results. Some women with recurrent cases of BV may benefit from evaluation and/or treatment of G vaginalis colonization in their sexual partner. This approach is controversial. Treat BV occurring in pregnant women to reduce the risk of pregnancy-associated complications related to infection. Although not tested by clinical trials, treatment prior to cesarean delivery, total abdominal hysterectomy, and insertion of an IUD is also recommended. DRUG TREATMENT : 1. ANTIBIOTICS - CLINDAMYCIN - METRONIDAZOLE - METRONIDAZOLE VAGINAL GEL/ CREAM
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
BLOOD SUGAR ( FASTING ), COMPLETE BLOOD COUNT