Table of ContentsDefinition / general | Terminology | Epidemiology | Etiology | Clinical features | Prognostic factors | Cytology description | Cytology images
Cite this page: Hasteh F. Bacterial vaginosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixcytologybacterialvaginosis.html. Accessed March 3rd, 2021.
Definition / general
- Common cause of vaginal discharge in young women, usually due to multiple microbes
- Also called "shift in flora", Gardnerella vaginalis, "clue cells"
- Most common cause of abnormal discharge in young women
- Common finding in women with SIL (HPV infection)
- Uncommon in postmenopausal women, except those with hormonal replacement therapy
- Risk factors include multiple sexual partners, IUD, prior pregnancy, medication, spermicides and smoking
- Gardnerella vaginalis in the most common cause (eMedicine)
- Usually it is multimicrobial (Gardnerella vaginalis, Prevotella, Mobiluncus, peptostreptococci, Mycoplasma hominis and Ureaplasma urealyticum)
- Increases in vaginal pH (> 4.5) can cause Gardnerella vaginalis to adhere more to squamous cells, causing the morphologic appearance of "clue cells"
- Discharge with "fishy" or ammonia-like odor in some patients
- Most patients are asymptomatic
- Pap smear is 80% sensitive and 87% specific; presence of "clue cells" is more sensitive and specific (Acta Cytol 2005;49:634)
- Complications are rare and include PID, infertility, postoperative infection, premature labor or low birth weight babies
- Clue cells are squamous cells covered by coccobacilli with extension to the cell edges (velvety coat or shaggy appearance)
- The entire cell does not need to be covered
- Lactobacilli and inflammatory cells are absent, unless there is another infectious process
- The small coccobacilli form a granular blue background (sandy background) on conventional smears
- In liquid based cytology, the background is cleaner than with conventional smears