What is required for a clinical diagnosis of bacterial vaginosis (BV)?

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

Clinical diagnosis of bacterial vaginosis (BV) relies on history, vaginal examination, and microscopic examination (see the Table under "Diagnostic tools" for a summary of the differential diagnoses). Emerging data support sending vaginal cultures in recalcitrant cases. [14]

Table. Differential Diagnosis of the Vaginitides (Open Table in a new window)

Clinical Elements

Bacterial Vaginosis

Trichomoniasis

Vaginal Candidiasis

Symptoms

Vaginal odor

+

+/-

-

Vaginal discharge

Thin, gray, homogenous

Green-yellow

White, curdlike

Vulvar irritation

+/-

+

+

Dyspareunia

-

+

-

Signs

Vulvar erythema

-

+/-

+/-

Bubbles in vaginal fluid

+

+/-

-

Strawberry cervix

-

+/-

-

Microscopy

Saline wet mount

Clue cells

+

-

-

Motile protozoa

-

+

-

KOH test

Pseudohyphae

-

-

+

Whiff test

+

+/-

-

pH

>4.5

>4.5

< 4.5


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