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You get the following results on a vaginal wet prep: pH 5 and a positive “whiff” test. Wouldn't you know it, the rest of the results got lost. With the information available, the most likely diagnosis is:

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The correct answer is B. You answered B.


Bacterial Vaginosis Risk Factors

  • Oral sex

  • Douching

  • Black race

  • Cigarette smoking

  • Sex during menses

  • Intrauterine device

  • Early age of sexual intercourse

  • New or multiple sexual partners

  • Sexual activity with other women

With bacterial vaginosis (BV), the vaginal flora’s symbiotic relationship shifts for unknown reasons to one in which anaerobic species overgrow and include Gardnerella vaginalis, Ureaplasma urealyticumMobiluncus species, Mycoplasma hominis, and Prevotellaspecies. Bacterial vaginosis (BV) is also associated with a significant reduction or absence of normal hydrogen peroxide-producing Lactobacillus species. Whether an altered ecosystem leads to lactobacilli disappearance or whether its disappearance results in the changes observed with BV is unclear.

In evaluating risks for BV, this condition is not considered by the Centers for Disease Control and Prevention (CDC) (2015) to be a sexually transmitted disease (STD). However, an increased risk of BV is associated with sexual contact with multiple and new male and female partners, and condom use lowers the risk (Table 3-2) (Fethers, 2008). Further, rates of STD acquisition are increased in affected women, and a possible role of sexual transmission in the pathogenesis of recurrent BV has been proposed (Atashili, 2008Bradshaw, 2006Wiesenfeld, 2003). Successful prevention of BV is limited, but elimination or diminished use of vaginal douches may be beneficial (Brotman, 2008Klebanoff, 2010).


Bacterial vaginosis is a risk factor for preterm birth and low birth weight. However, prospective treatment studies have yielded inconsistent results as to the benefit of screening and treating for bacterial vaginosis in pregnancy.

Gynecologic complications include postoperative infections following gynecologic surgery; acquisition of sexually transmitted diseases, including pelvic inflammatory disease; acquisition and transmission of HIV; and recurrent urinary tract infections.

Screening and treating for bacterial vaginosis prior to elective gynecologic procedures is recommended.



Bacterial vaginosis cure rates are 70–80%, and recurrence rates may be as high as 50% within 6 months.

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