How is bacterial vaginosis (BV) diagnosed?

Updated: Oct 25, 2018
  • Author: Philippe H Girerd, MD; Chief Editor: Michel E Rivlin, MD  more...
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Answer

In addition to the history and vaginal examination, microscopic examination is vital to the clinical diagnosis of BV.

On microscopic examination of the discharge, demonstration of 3 of the following 4 Amsel criteria is considered necessary to diagnose BV most accurately [2] :

  • Demonstration of clue cells on a saline smear (the most specific diagnostic criterion)

  • A pH greater than 4.5 (up to 90% of patients)

  • Characteristic thin, gray, and homogeneous discharge

  • Positive whiff test (up to 70% of patients)


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