BACTERIAL VAGINOSIS

DEFINITION
Bacterial vaginosis is an infection caused by an
imbalance of the normal vaginal flora and other
bacteria in the vagina.
 EPIDEMIOLOGY
VB is the most common vaginal infection in
women who are sexually active, the disease is
observed in 15% of women attending
gynecology clinic, 10- 25% of women and 33-
37% of pregnant women attending STI clinics.
 RISK FACTORS
Several factors are known to be a risk factor for
VB, namely:
• Sexual activity
• Douching
• Smoking
• Use of an IUD
 ETIOLOGY
Bacterial vaginosis is caused by an imbalance in
vaginal pH, decreased Lactobascilus sp. as
normal vaginal flora, or overgrowth of other
bacteria such as Gardnerella vaginalis,
Mobiluncus, Prevotella, Bacteroides, and
Mycoplasma sp.
 CLINICAL FEATURES
• Vaginal smell fishy smell like the smell of fish
• Duh looks homogeneous, thin, white colored
and stick to the walls of the vagina or often
appear on the labia or the fourchette
 DIAGNOSIS
• Amsel Criteria:
VB based their diagnosis at least three signs - signs:
vaginal secretions homogeneous white, vaginal fluid pH>
4.5. the fishy odor of vaginal fluids spilled 10% KOH (whiff
test), as well as on microscopic examination found Clue
cells.
• Kultur
G. vaginalis culture provides little benefit to diagnose VB
for G. vaginalis is vaginal flora so obtained also in normal
vaginal fluid, even in low concentrations.
• Gram
 TREATMENT
• Metronidazole oral therapy with a dose of 2 x 500
mg for 7 days or metronidazole gel 0.75% one full
applicator (5 g), intra vagina once a day for 5
days.
• Clindamycin oral therapy with a dose of 2 x 300
mg for 7 days or clindamycin cream 2% one full
applicator (5 g) when going to bed, for 7 days.
• The recommended alternative treatments such as
oral tinidazole 1 x 2 g for 2 days, intravaginal
clindamycin ovules 100 mg at bedtime for 3 days.
 COMPLICATION
VB is a risk factor for disorders in pregnancy, the
risk of premature birth and low birth weight.
Besides VB is also a risk factor makes it easy to
get other sexually transmitted infections,
namely gonorrhea, chlamydia, trichomoniasis,
genital herpes and Human Imunodeficiency
Virus (HIV).