Bacterial vaginosis

Gardner 1955.

Gardnerella vaginalis infection, amine colpitis.

Inbalance of the vaginal flora in favour of obligate anaerobic bacteria and Gardnerella vaginalis.

Frequent, up to 30% prevalence, among sex workers > 50%.

Risk factors are changing sexual partners, regular vaginal douches, etc.

Sexually transmitted infection with Gardnerella vaginalis. The proliferation of gram-negative.

Vulvovaginitis and colpitis with serous, thin, homogeneously whitish (no white stipples), discharge with a fishy odour. Amines are produced by anaerobic bacteria and smell like rotten fish.

• Anamnesis
  • Unprotected sexual intercourse?
  • Odorous, vaginal discharge?
• Bact. Smear
• Urethra smear?
  • Cultural evidence
• Note diagnostic criteria, namely 3 out of 4:
  1. Thin, homogeneous discharge
  2. High pH > 4.5 (normally the vagina is rather acidic, think Döderlein bacteria)
  3. 10% KOH on a sample of the discharge leads to increased fishy odour
  4. > 20% of the cells are "Clue-Cells"

Vulva, esp. vagina.

• Chronic inflammation in the vaginal area can favour HIV infection.
• Risk of premature birth increased by 2 to 4 times.

Condom.

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2. Edwards S. Balanitis and balanoposthitis: a review. Genitourin Med 1996;72:155-9.
3. Catlin BW. Gardnerella vaginalis: characteristics, clinical considerations, and controversies. Clin Microbiol Rev 1992;5:213-37.
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8. 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