1. What is the diagnosis?

Bacterial vaginosis
2. Give the basis for your diagnosis and criteria for your diagnosis?

Symptoms
- Musty or fishy vaginal odor, esp after sexual intercourse most frequent symptom
- Thin and gray white vaginal discharge like a thin paste of flour, mildly adherent to vaginal walls
- Physiologic discharge on the most dependent area of the vagina
- rare to have pruritus/irritation, 10% frothy
- Four criteria
1. Homogenous vaginal discharge
2. Vagina pH of 4.5 or higher
3. Vaginal discharge has an amantine-like odor when mixed with KOH = Whiff test
4. Classic Findings on wet smear of vaginal discharge clumps of bacteria and clue cells (vaginal epithelial cell
with clusters of bacteria adherent to their external surface) more than 20% of the number of the vag epith cells

3. Discuss and differentiate each one

Bacterial vaginosis (BV), formerly known as nonspecific vaginitis, was named because bacteria are the
etiologic agent in this infection and an associated inflammatory response is lacking.
BV is the most common cause of vaginitis and the most common infection encountered in the outpatient
gynecologic setting. An increase in vaginal discharge and vaginal malodor caused by a change in the
vaginal flora characterizes BV. The vaginal discharge of BV is characteristically described as a thin, gray,
homogeneous fluid that is adherent to the vaginal mucosa.
In BV, the vaginal flora becomes altered through known and unknown mechanisms, causing an increase in
the local pH. This may result from a reduction in the hydrogen peroxideproducing lactobacilli.
Lactobacilli are large rod-shaped organisms that help maintain the acidic pH of healthy vaginas and inhibit
other anaerobic microorganisms through elaboration of hydrogen peroxide. Normally, lactobacilli are found
in high concentrations in the healthy vagina. In BV, the lactobacilli population is reduced greatly, while
populations of various anaerobes and G vaginalis are increased