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Sunday, September 21, 2008

Bacterial Vaginosis


Description

* This is an infection in the vagina that occurs because there is an imbalance between "good", normal vaginal bacteria (i.e., Lactobacillus), and so-called "bad bacteria" (an overgrowth of the bacteria Gardnerella vaginalis, Bacteroides, Mycoplasma Hominis, and Mobiluncus).
* It is most common in women of childbearing age, those with IUD's, those who douche, and those with multiple sexual partners. It is also seen in sexually inactive women. The cause is unknown, but it is thought to stem from the loss of a normal balance of vagina flora.

Symptoms

* Vaginal discharge with a bad/fishy odor-thin, milky-white or gray discharge
* Vaginal irritation or itching is sometimes present
* Redness outside the vagina
* There may be burning during urination
* There may be no symptoms at all
* There may be an increased chance of developing pelvic inflammatory disease (PID), or an increased risk for other sexually transmitted diseases.
* Women with bacterial vaginosis who are HIV positive may have a higher chance of transmitting the virus to their sexual partners (as well as being infected by a HIV positive partner) than women without bacterial vaginosis.



Diagnosis

* Microscope slide mount shows "clue cells"

Similar Conditions

* Candida vaginitis (yeast infection)
* Trichomonas vaginalis
* Gonorrhea
* Chlamydia

Treatment

* Flagyl (Metronidazole) by mouth
* Clindamycin by mouth
* Clindamycin vaginal cream
* Metronidazole gel vaginally
* Use protection (condoms) at all times
* Do not douche

MISC
Pregnancy Concerns

* Pregnant women with symptomatic bacterial vaginosis or a history of pre-term (premature) labor should probably be treated. In patients that have no symptoms and no history of pre-term labor, treatment of bacterial vaginosis does not seem to be needed, with no increase in the risk of pre-term labor.


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