Bacterial Vaginosis

Gardner 1955.

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: 
  1. thin, homogeneous discharge 
  2. high pH value > 4.5 (normally the vagina is rather acidic, think of Döderlein bacteria) 
  3. 10 % KOH on a sample of the effluent leads to an increased fish smell
  4. > 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.

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