Last Updated: 2020-08-07
Gardnerella vaginalis infection, amine colpitis.
Imbalance of the vaginal flora in favour of obligatory anaerobic bacteria and Gardnerella vaginalis.
Common, up to 30% prevalence, in sex workers > 50%.
Risk factors are changing sexual partners, regular vaginal showers, etc.
Sexually transmitted infection with Gardnerella vaginalis. The proliferation of gram-negative.
Vulvovaginitis and colpitis with serous, thin, homogeneously whitish (no white spots), discharge with fishy odour. Amines are formed by anaerobic bacteria and smell like spoiled fish.
- Medical history
- Unprotected sexual intercourse?
- Smelly, vaginal discharge?
- Bact. Swab
- Urethra smear?
- Cultural evidence.
- Observe diagnostic criteria, namely 3 out of 4:
- thin, homogeneous discharge
- high pH value > 4.5 (normally the vagina is rather acidic, think of Döderlein bacteria)
- 10 % KOH on a sample of the effluent leads to an increased fish smell
- > 20% of the cells are "Clue-Cells
Vulva, especially vagina.
- Chronic inflammation in the vaginal area can promote HIV infection.
- The risk of premature birth is 2 to 4 times higher.
- Co-treatment of the partner - in fact many men have G. vaginalis in the urethra!
- Iodine-povidone solution, Vag Ovula
- Metronidazole Vag Ovula
- Metronidazole p.o. 400-500 mg 2x daily for 5-7 days (alternative: Metronidazole 2g p.o. as a single treatment or Clindamycin 300mg 2xtgl. p. o. for 7 days).
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- Sherrard et. al. 2018 European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) guideline on the management of vaginal discharge. International Journal of STD & AIDS 2018, Vol. 29(13) 1258–1272