A 40-year-old woman presented to the gyencologist with complaint of profuse vaginal discharge. There was no discharge from the cervical os on the speculum examination. The diagnosis of bacterial vaginosis was made based upon all of the following findings on microscopy except:
Ans. (c) Abundance of polymorphs Ref Shaw's 13/e p 129: COCDT 10, p 670 Bacterial Vaginosis Defined as alteration in normal vaginal flora rather than true infection Causative organism: - G. vaginalis H. vaginalis - Mobiluncus Microscopy of vaginal secretions in bacterial vaginosis shows: - Characteristic clue cells - Decreased or absent lactobacillus - Decreased leucocytes. Clinical criteria for diagnosis: - Homogenous white non inflammatory discharge with fishy odour. - Microscopic presence of >20% clue cells. Vaginal discharge with pH > 4.5 - Fishy odor with or without addition of 10% KOH. Treatment: Metronidazole for both pregnant and non-pregnant women. Remember: Clue cells represent epithelial cells adherant to G. vaginalis. Bacterial vaginosis is most prevalent vaginal infection.
Abundance of gram variable coccobacilli
Absence of Lactobacilli
Abundance of polymorphs
Presence of clue cells