Diagnose Bacterial Vaginosis

Doctors will use various methods of detection when faced with a potential case of bacterial vaginosis (BV). A physician will not pursue further testing of BV until a woman describes or shows symptoms for the condition. He or she may also test for bacterial vaginosis if you are going to have a hysterectomy or surgical abortion, or have suffered preterm delivery in a previous pregnancy.

When diagnosing bacterial vaginosis, a doctor may:

• Consider a past history with the condition and reoccurring symptoms, especially if the patient suffered this type of infection during a pregnancy.

• Perform a pelvic or vaginal exam to visually pinpoint common signs and symptoms for BV. During the exam, a doctor examines the appearance of the vaginal lining and cervix. They will also perform a manual examination of the ovaries and uterus. If the cervix is tender, the woman may have a more serious infection, such as chlamydia or gonorrhea. Samples are then collected to pinpoint the source of the symptoms.

• Take a sample of vaginal discharge, which is tested to see the presence of bacteria and other indicators for the condition.

Laboratory Tests for Bacterial Vaginosis [1]

Taking a look at vaginal discharge under a microscope can determine whether a patient’s infection is caused by bacterial vaginosis or by another infection, such as yeast or trichmoniasis. A doctor may consider a wide range of lab tests to diagnose bacterial vaginosis, including the following methods of detection:

a) Gram Strain:

A special dye is applied to a microscope slide that contains a sample of vaginal discharge. The dye causes certain types of bacteria (Gram-positive) to turn a shade of purple, while other bacteria (Gram-negative) turns pink. Women with bacterial vaginosis are infected with Gram-negative bacteria (such as Gardnerella vaginalis) – the most common type.

b) Oligonucleotide Probes:

Genetic material (DNA) associated with bacterial vaginosis is detected by using this particular test. Although this type of testing is quite accurate, it is not regularly available in most laboratories.

c) Vaginal pH:

The pH of a sample of vaginal discharge can be used to identify the presence of an infection. Normal pH of the vagina is between 3.8 and 4.5. When a woman has bacterial vaginosis, the pH of her vagina rises above 4.5.

d) Wet Mount:

A doctor can determine the presence of bacterial vaginosis by placing a sample of vaginal discharge mixed with normal saline (salt) solution on a microscope slide. White blood cells in the sample will alert a lab tech of the presence of bacteria and infection. They will also look for unusual cells known as clue cells – a reliable indicator of bacterial vaginosis.

e) Whiff Test:

If a sample of vaginal discharge produces a strong “fishy” odor after several drops of a potassium hydroxide (KOH) solution is added – the result is usually a diagnosis of bacterial vaginosis.

Overall, when tests show the presence of clue cells, an increased vaginal pH, and a positive whiff test result – a doctor can accurately diagnose bacterial vaginosis. While a Pap test is not a standard test used to detect bacterial vaginosis, the condition can be diagnosed during a routine screening [2].

whiff test for bv

[1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2095014/#__secid3964930
[2] http://www.webmd.com/sexual-conditions/tc/bacterial-vaginosis-exams-and-tests

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