Unifying Concepts

Diagnostic Findings in Vaginal Secretions

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
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

* 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.



  1. Paavonen J, Brunham RC. Bacterial Vaginosis and Desquamative Inflammatory Vaginitis. N Engl J Med. 2018 Dec 6;379(23):2246-2254. [Medline]
  2. Bagnall P, Rizzolo D. Bacterial vaginosis: A practical review. JAAPA. 2017 Dec;30(12):15-21. [Medline]


Created Mar 15, 2019.

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