A female presents complaining of a grayish, watery vaginal discharge. The KOH prep does not reveal any hyphae. Clue cells are identified on the wet mount. A paucity of WBCs is noted. What diagnosis is most likely?
Answer: D
Bacterial Vaginosis
Clue cells mean BV
Know Your Content Blueprint
Bacterial Vaginosis is covered in the NCCPA™ Content Blueprint Reproductive System (8%)
- FISHY, grey, scant, THIN, STICKY
- PH > 4.5 (BACTERIA = BASIC)
- Wet-prep shows epithelial cells with bacteria coating on surface = “clue cells”
- KOH testing causes the release of amine odor (+ whiff test)
- First Line Treatment:
- Metronidazole: 500 mg PO b.i.d. × 7 days
- Metronidazole gel 0.75%: 5 g intravaginally daily × 5 days
- Clindamycin 2% cream: 5 g intravaginally qhs × 7 days
Review Topic: Vaginitis