Vaginal infections affect a woman’s quality of life by causing frustration, anxiety, sexual dysfunction, and vulvovaginal discomfort.
Diagnostic Findings in Vaginal Secretions
| Variable | Healthy Vaginal Flora | Bacterial Vaginosis | Desquamative Inflammatory Vaginitis |
| pH | <4.7 | ≥4.7 | ≥4.7 |
| Amine odor | Negative | Positive | Negative |
| Clue cells | Absent | Present | Absent |
| Epithelial cells | Mature squamous cells | Mature squamous cells | Immature parabasal cells |
| Neutrophils | Absent | Absent | Present |
| Flora | Sparse monomorphic bacilli | Abundant polymorphic coccobacilli | Abundant polymorphic cocci and bacilli |
| Microbiome | Lactobacilli | Gardnerella vaginalis, Atopobium vaginae, others | Escherichia coli, group B streptococci, others |
| CST* | I, II,V | III, IV | IV |
* Community state type (CST) I is dominated by Lactobacillus crispatus, CST II by L. gasseri, CST III by L. iners, and CST V by L. jensenii; CST IV is composed of a polymicrobial mixture of strict and facultative anaerobes.
References:
- Paavonen J, Brunham RC. Bacterial Vaginosis and Desquamative Inflammatory Vaginitis. N Engl J Med. 2018 Dec 6;379(23):2246-2254. [Medline]
- Bagnall P, Rizzolo D. Bacterial vaginosis: A practical review. JAAPA. 2017 Dec;30(12):15-21. [Medline]
Created Mar 15, 2019.
