Bacterial vaginosis BV is a disease of the vagina caused by excessive growth of bacteria. The discharge is usually white or gray in color. Burning with urination may occur. BV is caused by an imbalance of the naturally occurring bacteria in the vagina. Usually treatment is with an antibiotic, such as clindamycin or metronidazole. These medications may also be used in the second or third trimesters of pregnancy. However, the condition often recurs following treatment. Probiotics may help prevent re-occurrence. BV is the most common vaginal infection in women of reproductive age. Common symptoms include increased vaginal discharge that usually smells like fish. The discharge is often white or gray in color. There may be burning with urination. Occasionally, there may be no symptoms. The discharge coats the walls of the vagina, and is usually without significant irritation, pain, or erythema redness , although mild itching can sometimes occur. By contrast, the normal vaginal discharge will vary in consistency and amount throughout the menstrual cycle and is at its clearest at ovulation —about two weeks before the period starts. Some practitioners claim that BV can be asymptomatic in almost half of affected women, [16] though others argue that this is often a misdiagnosis. Healthy vaginal microbiota consists of species which neither cause symptoms or infections, nor negatively affect pregnancy. It is dominated mainly by Lactobacillus species. While the infection involves a number of bacteria, it is believed that most infections start with Gardnerella vaginalis creating a biofilm , which allows other opportunistic bacteria to thrive. One of the main risks for developing BV is douching , which alters the vaginal flora and predisposes women to developing BV. Department of Health and Human Services and various medical authorities, for this and other reasons. BV is a risk factor for pelvic inflammatory disease , HIV, sexually transmitted infections STIs , and reproductive and obstetric disorders or negative outcomes. It is possible for sexually inactive persons to develop bacterial vaginosis. Bacterial vaginosis may sometimes affect women after menopause. Also, subclinical iron deficiency may correlate with bacterial vaginosis in early pregnancy. The bacteria associated with BV have been isolated from male genitalia. BV microbiota has been found in the penis , coronal sulcus , and male urethra , in the male partners of infected females. Another mode of transmission of the BV-associated microbiota is to a female sexual partner via skin-to-skin transfer. BV may be transmitted via the perineal enteric bacteria from the microbiota of the female and male genitalia. To make a diagnosis of bacterial vaginosis, a swab from inside the vagina should be obtained. These swabs should be tested for:. Two positive results in addition to the discharge itself are enough to diagnose BV. If there is no discharge, then all three criteria are needed. The Center For Disease Control CDC defines STIs as "a variety of clinical syndromes and infections caused by pathogens that can be acquired and transmitted through sexual activity. In clinical practice BV can be diagnosed using the Amsel criteria: At least three of the four criteria should be present for a confirmed diagnosis. Gardnerella vaginalis is the main culprit in BV. Gardnerella vaginalis is a short rod coccobacillus. Hence, the presence of clue cells and gram variable coccobacilli are indicative or diagnostic of bacterial vaginosis. The Nugent Score is now rarely used by physicians due to the time it takes to read the slides and requires the use of a trained microscopist. The scores are as follows:. View multiple fields note that this factor is less important — scores of only 0—2 are possible. DNA hybridization testing with Affirm VPIII was compared to the Gram stain using the Nugent criteria. Some steps suggested to lower the risk include: One review concluded that probiotics may help prevent re-occurrence. Early evidence suggested that antibiotic treatment of male partners could re-establish the normal microbiota of the male urogenital tract and prevent the recurrence of infection. It also found that such treatment may lead treated sexual partners to report increased adverse events. Treatment is typically with the antibiotics metronidazole or clindamycin. Other antibiotics that may work include macrolides , lincosamides , nitroimidazoles , and penicillins. Bacterial vaginosis is not considered a sexually transmitted infection , and treatment of a male sexual partner of a woman with bacterial vaginosis is not recommended. A Cochrane review found tentative but insufficient evidence for probiotics as a treatment for BV. Although previously considered a mere nuisance infection, untreated bacterial vaginosis may cause complications, such as increased susceptibility to sexually transmitted infections including HIV and pregnancy complications. It has been shown that HIV-infected women with bacterial vaginosis BV are more likely to transmit HIV to their sexual partners than those without BV. There is also a correlation between the absence of vaginal lactobacilli and infection by Neisseria gonorrhea and Chlamydia trachomatis. BV is a risk factor for viral shedding and herpes simplex virus type 2 infection. BV may increase the risk of infection with or reactivation of human papillomavirus HPV. In addition, bacterial vaginosis an intercurrent disease in pregnancy may increase the risk of pregnancy complications, most notably premature birth or miscarriage. BV is associated with gynecological and obstetric complications. Data suggest an association between BV, tubal factor infertility , and pelvic inflammatory disease. Women with BV who are treated with in vitro fertilization have a lower implantation rate and higher rates of early pregnancy loss. BV is the most common infection of the vagina in women of reproductive age. From Wikipedia, the free encyclopedia. Bacterial vaginosis Synonyms Anerobic vaginositis, non-specific vaginitis, vaginal bacteriosis, Gardnerella vaginitis [1] Micrograph of bacterial vaginosis — cells of the cervix covered with rod-shaped bacteria, Gardnerella vaginalis arrows. List of bacterial vaginosis microbiota. Retrieved 3 March National Institute of Child Health and Human Development. Expert opinion on pharmacotherapy. American Journal of Obstetrics and Gynecology. Seminars in Reproductive Medicine. Retrieved 4 March Centers for Disease Control and Prevention. Retrieved 2 Mar The Cochrane database of systematic reviews 1: Journal of Infections Diseases. The Cochrane database of systematic reviews 4: Diagnostic criteria and microbial and epidemiologic associations". Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: Br J Obstet Gynecol ; Clinical Effectiveness Group, British Association for Sexual Health and HIV BASHH. Retrieved 6 May Cochrane Database of Systematic Reviews Retrieved 25 October Cochrane Database Syst Rev 3: Cochrane Database Syst Rev 4: Br J Gen Pract. Archives of gynecology and obstetrics. Archived from the original on 3 December Retrieved 4 December Vijaya; McNellis, Donald; Regan, Joan A. Christopher; Klebanoff, Mark A. New England Journal of Medicine. N76 ICD - 9-CM: Female diseases of the pelvis and genitals N70—N99 , — Endometriosis of ovary Female infertility Anovulation Poor ovarian reserve Mittelschmerz Oophoritis Ovarian apoplexy Ovarian cyst Corpus luteum cyst Follicular cyst of ovary Theca lutein cyst Ovarian hyperstimulation syndrome Ovarian torsion. Female infertility Fallopian tube obstruction Hematosalpinx Hydrosalpinx Salpingitis. Female infertility Recurrent miscarriage. Cervical dysplasia Cervical incompetence Cervical polyp Cervicitis Female infertility Cervical stenosis Nabothian cyst. Dyspareunia Hypoactive sexual desire disorder Sexual arousal disorder Vaginismus. Fistulae Rectovaginal Ureterovaginal Vesicovaginal Prolapse Cystocele Enterocele Rectocele Sigmoidocele Urethrocele. Pelvic congestion syndrome Pelvic inflammatory disease. Retrieved from " https: Bacterial vaginosis Sexually transmitted diseases and infections Inflammatory diseases of female pelvic organs Probiotics. Navigation menu Personal tools Not logged in Talk Contributions Create account Log in. Views Read Edit View history. Navigation Main page Contents Featured content Current events Random article Donate to Wikipedia Wikipedia store. Interaction Help About Wikipedia Community portal Recent changes Contact page. Tools What links here Related changes Upload file Special pages Permanent link Page information Wikidata item Cite this page. In other projects Wikimedia Commons. This page was last edited on 19 June , at Text is available under the Creative Commons Attribution-ShareAlike License ; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Privacy policy About Wikipedia Disclaimers Contact Wikipedia Developers Cookie statement Mobile view. Anerobic vaginositis, non-specific vaginitis, vaginal bacteriosis, Gardnerella vaginitis [1]. Micrograph of bacterial vaginosis — cells of the cervix covered with rod-shaped bacteria, Gardnerella vaginalis arrows. Gynecology , infectious disease. Vaginal discharge that often smells like fish, burning with urination [2]. Early delivery among pregnant women [3]. Imbalance of the naturally occurring bacteria in the vagina [4] [5]. Douching , new or multiple sex partners , antibiotics , using an intrauterine device [5]. Testing the vaginal discharge [6]. Vaginal yeast infection , infection with Trichomonas [7]. Clindamycin or metronidazole [6]. Adnexa Ovary Endometriosis of ovary Female infertility Anovulation Poor ovarian reserve Mittelschmerz Oophoritis Ovarian apoplexy Ovarian cyst Corpus luteum cyst Follicular cyst of ovary Theca lutein cyst Ovarian hyperstimulation syndrome Ovarian torsion.
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