Bacterial vaginosis

What is it bacterial vaginosis?

Bacterial vaginosis is a common cause of vaginal abnormalities. download and bad smell in women. Some women have identical vaginal findings wet mount and culture but it has no symptoms

Bacterial vaginosis is neither sexually transmitted nor contagious. It was previously called nonspecific vaginitis, which implies inflammation - inflammation is absent in bacterial vaginosis.

Who Gets Bacterial Vaginosis?

Bacterial vaginosis affects women of reproductive age. Similar laboratory findings are common in postmenopausal women.

What is the cause of bacterial vaginosis?

Bacterial vaginosis is due to a disturbance of the normal bacterial balance (or microbiome) in the vagina. Lactobacilli are generally the most common bacteria in the vagina.In bacterial vaginosis, there is an overgrowth of other bacteria, especially Gardnerella, Bacteroides, Peptostreptococcus and Mobiluncus species. These are anaerobic bacteria, that is, they grow in the absence of oxygen.

Predisposing factors for bacterial vaginosis include recent use of broad-spectrum antibiotics, decreased estrogen production (eg, postmenopause), intrauterine device (IUD) and a greater number of sexual partners. It is associated with elevation pH > 4.5 inside the vagina.

What are the clinical features of bacterial vaginosis?

The odor of creamy white foamy discharge is the most common complaint in bacterial vaginosis, with a positive "odor" (bad odor) test. the vulva and the vagina are not inflamed and any vaginal burning or itching must be explained by another cause of vaginitis, especially aerobic vaginitis Discharge can cause mild irritation of the skin around the vagina.

In most women, there are no complications from bacterial vaginosis. In pregnancy, there have been reports associating bacterial vaginosis with preterm labor and inflammation around the fetus (chorioamnionitis). These complications may have been due to aerobic vaginitis, which has recently been recognized as distinct from bacterial vaginosis.

How is the diagnosis of bacterial vaginosis made?

In bacterial vaginosis, a wet vaginal smear shows that normal vaginal lactobacilli are replaced by multiple small cocci. These are small, round bacteria, while lactobacilli are elongated. 'Clue' cells are also seen; these are epithelial cells of the lining of the vagina with many of the cocci attached to its cells. Vaginal pH is elevated (> 4.5) in most patients, unlike vulvovaginal candidiasis when reduced below 4.5.

The typical flora of bacterial vaginosis can be a normal finding in asymptomatic postmenopausal women.

Nugent criteria can be used to quantify Gram stain findings [1].

What is the treatment for bacterial vaginosis?

Bacterial vaginosis fluctuates naturally, so treatment is not always necessary. Treatment of bacterial vaginosis during pregnancy is recommended to reduce any risk of complications related to infection.

• Avoid douching or bathing with bubble bath or other non-pH balanced detergents.
• Lower vaginal pH to promote restoration of normal vaginal lactobacilli (eg, Vaginal Vitamin C / Ascorbic Acid 250mg [2], Intravaginal Lactigel ™ once daily at night for 7 days, or Multi-Gyn Actigel ® twice a day for 5 days)
• Insert vaginal tablets containing the antiseptic, dequalinium 10 mg, once a day for 6 days.
• Insert 600 mg boric acid vaginal capsules or pessaries daily for 14 days and twice a week for 6-12 months to prevent a reappearance.
• Use intravaginal clindamycin cream or metronidazole gel.
• Oral antibiotics: metronidazole 2 g stat and 750 mg once a week for 6 months are used in serious diseases; tinidazole and secnidazole are alternatives.
• Estrogen cream may be suitable for postmenopausal women with atrophic vulvovaginitis

Metronidazole can be used in pregnancy.

There have been promising preliminary reports from the effectiveness of the vaginal microbiome transplant of donor women in bacterial vaginosis.