Currently, bacterial vaginosis is considered to be caused by an increase in Gardnerella and a decrease in Lactobacillus, leading to changes in the vaginal ecosystem and resulting in disease. Clinically, it manifests as an increase in vaginal discharge pH, with clue cells visible in wet mount microscopy, and Gram staining of smears reveals the aforementioned changes in bacterial flora. Bacterial vaginosis is associated with sexual activity and promiscuity, with a significantly higher incidence among sexually active women compared to normal individuals. Previously considered a benign condition, bacterial vaginosis is now widely recognized as a risk factor for acute salpingitis, premature labor, and neonatal and perinatal complications. Those with vaginal flora imbalance but no symptoms are referred to as asymptomatic bacterial vaginosis. Treatment for this condition involves restoring the vaginal flora to normal, alleviating symptoms, and relieving discomfort.

bubble_chart Diagnosis

Increased leucorrhea, vaginal discharge has the following characteristics: 1. Homogeneous discharge, leucorrhea is gray or gray-green, uniform like paste in consistency, may be accompanied by many bubbles; 2. pH as high as 5.0-5.5; 3. A fishy odor, due to high amine levels; 4. Clue cells can be found in the discharge, which are epithelial cells coated with large amounts of Gardnerella, giving them a stippled appearance.

1. Smear to find clue cells and Gram-negative coccobacilli; 2. Whiff test: Add a drop of 10% KOH solution to the discharge, a "fishy" ammonia odor can be detected, caused by amines releasing ammonia upon contact with alkali; 3. Culture; 4. Fluorescent antibody testing. Clinical diagnosis can be made when 3 or 4 criteria are met, including homogeneous discharge, pH > 4.5, positive whiff test, or the presence of clue cells. Other laboratory tests can assist in diagnosis. This condition should be differentiated from genital candidiasis and vaginal trichomoniasis. [Treatment principles] 1. The goal of treatment is to alleviate symptoms. 2. Only symptomatic BV patients require treatment.

1. Cured: Symptoms disappear, leucorrhea is normal, laboratory tests show normal pH, negative amine test, and no clue cells observed; 2. Improved: Most clinical symptoms disappear. Homogeneous leucorrhea decreases by 30%, laboratory tests show pH close to normal and amine test is positive; 3. Not cured: Symptoms and laboratory test results remain the same as before treatment.