Bacterial Vaginosis or Vaginitis

Bacterial Vaginosis/Vaginitis

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Bacterial vaginosis/vaginitis is an intravaginal bacterial infection due to the overgrowth of bacteria other than the normal flora of the vagina. There is no inflammation of the mucosal lining of the vagina so better preferred as bacterial vaginosis. Bacterial vaginosis is a common vaginal problem of sexually active females.

Causative Organisms:-

Gardenela vaginali/Haemophilus vaginalis.

Other associated organisms are :  Bacteroides, Peptococcus, Mycoplasm hominis.

Causative factors: 

• Decreased lactobacillus, a normal vaginal flora.
• Altered vaginal pH.
• Unprotected sex.
• Multiple sex partners.
• Infection from sanitary pads using a long time during menstruation.
• Douching with deodorant, perfumed soap, etc may alter normal flora.
  
  
  

Clinical Features:-

Bacterial Vaginosis

The most Common C/F are:

Creamy vaginal discharge

The fishy smell of discharge, gets worse after intercourse.

The discharge is Greyish-white and adherent to the vaginal wall.

Itching of vulva/vagina.

Burning micturition.

Dyspareunia, pain during intercourse.

Complications:-

Recurrent infection leading to pelvic inflammatory disease(PID).

Vaginal cellulitis.

Endometritis.

Chorioamnionitis.

Pregnancy complications; 

Preterm Rupture of Membrane(PROM). 

Preterm Birth.

Recurrent abortion especially in the 2nd trimester.

Low birth weight baby.

Intrauterine growth retardation of foetus.

Diagnosis:-

Amsel's 4 diagnostic Criteria:

1. Homogenous vaginal discharge
2. Litmus paper test,Vaginal pH > 4.5
3. Positive WHIFF TEST
4. Presence of Clue cells ( >20% of clue cells)

Blood Examination: total leukocyte count and differential count.

M/E of vaginal secretions: Gram Staining for detection of bacteria.

          presence of clue cells.

bacterial overgrowth

Treatment:-

Metronidazole 200 mg orally thrice daily for 7 days.

Probiotics like lactobacillus etc.

Clindamycin 2%, metronidazole 0.75% gel for intra vaginal application for 5 days.

Intawash vaginal wash after each toilet.

Treatment is given to both partners simultaneously.

Prognosis:-

Cure Rate is > 80%

It is better to consult your family physician for better treatment for Bacterial vaginosis