References:
- Global Infectious Diseases and Epidemiology Online Network: Infectious Diseases of the Philippines, 2013 eBook Edition, ISBN 978-1-61755-582-4, by Stephen Berger. Accessed here.
| Agent | BACTERIUM. Gardnerella vaginalis (facultative gram-negative bacillus), Mobiluncus curtisii, Mobiluncus mulieris, Prevotella, et al. |
| Reservoir | Human |
| Vector | None |
| Vehicle | Sexual contact—these are normal flora in 14% of girls and 70% of women. |
| Incubation Period | Unknown |
| Diagnostic Tests | Identification of “clue cells” or positive KOH test in vaginal discharge. Culture. |
| Typical Adult Therapy | Metronidazole 500 mg BID X 7d OR Tinidazole 2 g PO daily X 3d OR Clindamycin 300 mg BID X 7d + intravaginal Clindamycin or Metronidazole Also treat sexual partner |
| Typical Pediatric Therapy | Metronidazole 7.5 mg/kg BID X 7d |
| Clinical Hints | Thin vaginal discharge - “fishy” odor when mixed with KOH; mild to moderate pruritus; occasionally urethritis in sexual partner. |
| Synonyms | Gardnerella, Gardnerella vaginalis, Mobiluncus. |
The diagnosis of bacterial vaginosis required three of the following: 1-3
- A white, noninflammatory vaginal discharge or coating
- The presence of clue cells 4
- A vaginal pH above 4.5
- A fishy odor following addition of 10% KOH to the vaginal discharge (presumably due to liberated trimethylamine). Note that routine culture is unnecessary.
Sequelae of bacterial vaginosis include preterm birth and neonatal distress, low birth weight, chorioamnionitis, cervicitis, scalp abscess of the newborn, an increased risk of late miscarriage, and maternal infection.
- Some studies have suggested a correlation between bacterial vaginosis and infertility.
- Bacterial vaginosis may increase the risk for acquisition of HIV infection.
- Bacterial vaginosis may predispose to urinary tract infection 20 and endometritis.
Gardnerella vaginalis has rarely been associated with balanitis, urethritis, urinary tract infections, asymptomatic bacteremia and infectious endocarditis in adult males.
Cases of osteomyelitis, discitis and septic arthritis due to Gardnerella vaginalis have been reported.