Gardnerella Vaginalis

_Pleomorphic, gram-variable bacillus that causes bacterial vaginosis (infection of vagina by bacteria). Gram variable stain: pink and purple on wall

_Alterations in natural vaginal flora such as sexual activity may lead to the proliferation and overgrowth of G. vaginalis, leading to bacterial vaginosis. However, bacterial vaginosis is not a sexually-transmitted infection.

• normally maintained by lactobacillus at 4.0-4.5

  Bacterial overgrowth disrupts normal flora:

  

_Risks for changing flora

• Recent antibiotic use

• Decreased estrogen production

• New sexual partner

• Douching

• Common in pregnant women

_Women with bacterial vaginosis are mainly asymptomatic. Symptomatic women typically present with off-white, thin, and homogenous vaginal dischargeand/or fishy vaginal odor.

• pregnant women at risk of spontaneous abortion (Foster)

  

  Fishy smell, thin white on vulva:

  

_Diagnosis of bacterial vaginosis is made based on the presence of at least three of the following four criteria:

• Homogenous, thin, grayish-white discharge that smoothly coats the vaginal walls

• Vaginal pH greater than 4.5

• Positive whiff-amine test, which is characterized by the presence of fishy odor when KOH is added to a sample of vaginal discharge

  Dog: KOH whiff

  

_Clue cells on saline wet mount Clue cells: Clue

_Treatment for bacterial vaginosis includes metronidazole or clindamycin.