A 28-year-old female presents with thin, homogeneous, off-white vaginal discharge with a characteristic 'fishy' odor that worsens after intercourse. Microscopic examination of vaginal wet mount demonstrates clue cells and a positive whiff test with 10% KOH. What is the diagnosis?
Answer and explanation
Correct answer: B. Bacterial vaginosis
- Step 1: Bacterial vaginosis results from an overgrowth of anaerobic bacteria (Gardnerella vaginalis, Mobiluncus) replacing protective hydrogen peroxide-producing lactobacilli.
- Step 2: Amsel criteria require 3 of 4: 1) Homogeneous thin discharge, 2) Vaginal pH > 4.5, 3) Positive whiff test (amine odor), 4) Clue cells (epithelial cells studded with adherent bacteria) on >= 20% of cells.
- Step 3: Treatment is oral or topical metronidazole.
Answer
Bacterial vaginosis.
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