Tuesday, 16 November 2010

MRCP revision battle 51.7: Bacterial vaginosis

Bacterial vaginosis is caused by an overgrowth of bacteria.  Lactobacillus tend to predominate.

It produces a thin white-grey discharge with a fishy odour.
It is not normally itchy or sore.

Diagnosis is made by Amsel's criteria, which requires 3 of the following 4:
  • thin grey-white discharge
  • fishy odour on adding an alkali
  • pH >4.5 (normal pH 3.8-4.2)
  • clue cells on microscopy

Treatment is given to symptomatic ladies.
Options include metronidazole and clindamycin.