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Bacterial Vaginosis

Updated : December 12, 2022





Background

Bacterial vaginosis is a disorder brought on by an overabundance of the natural flora in the vagina. The most typical clinical sign of this is an increase in fishy-smelling vaginal secretions. Typically, the discharge is thin and can be either white or grey in color.

Women who have been confirmed with vaginosis are more likely to contract other STIs, & expectant women are more likely to give birth before their due date.

Epidemiology

The majority of genital infections in females of reproductive age, known as bacterial vaginosis, are thought to affect 5 to 70 percent of females. It’s interesting to note that, globally, this illness is shown to be least common in Europe and Asia and most common in several regions of Africa.

Around 30 percent of women in the USA between the ages of 14 and 49 are afflicted; however, rates vary among ethnic groups and are particularly prevalent among non-white women (32 percent Mexican Americans, 51 percent African Americans).

According to epidemiological research, women who have had several sex partners, are alone, started having sex at a young age, work as female sex workers, and regularly touch are more likely to report having bacterial vaginosis.

Anatomy

Pathophysiology

The disequilibrium of the naturally existing microbial composition that results in bacterial vaginosis is defined by changes in both the predominant kind of bacteria involved and an increase in the overall number of bacteria involved. The typical vaginal microbiome is dominated by Lactobacilli genera. A decrease in Lactobacilli, in general, is linked to bacterial vaginosis.

Gardnerella vaginalis is assumed to be the primary cause of the majority of bacterial vaginosis infestations; however, the exact cause is still unknown. Gardnerella vaginalis forms a biofilm that enables other opportunistic microbes to proliferate inside the vagina. The connection between BV and a higher risk of developing STIs is based on the fact that BV creates a window of opportunity for other genital bacteria to enter the upper reproductive tract.

In addition, BV causes an increase in the release of endotoxins that promote cytokine & prostaglandin synthesis in the vagina, as well as the accumulation of enzymes that hinder the ability of donor leukocytes to combat infection.

Etiology

The function of transmissibility in bacterial vaginosis is still not well understood, despite the fact that it is not regarded as an infection transmitted sexually. Bacterial vaginosis appears to be caused by an imbalance in the normal microbe flora of the vagina brought on by the transmission of bacteria between people during sexual activity.

This illness is typically brought on by an excess of anaerobes and maybe a decrease in the usual Lactobacilli that normally produce hydrogen peroxide. Gardnerella vaginalis can spread between sex partners when mucosa comes into close contact or when shared sex devices are used.

Gardnerella vaginitis was the name given to bacterial vaginosis in the past because it was thought that these bacteria were to blame for the illness. The term “bacterial vaginosis,” which is more recent, emphasizes the possibility that a variety of alternative bacteria that naturally exist in the vagina may proliferate excessively and result in illness.

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

clindamycin 

300

mg

orally

twice a day

7

days



secnidazole 

1

packet

Orally 

daily



tinidazole 

2g/day orally for two days or 1g orally every day for five days



metronidazole 

500 mg per oral two times daily for seven days
if taking a single dose, 2 gm oral should be the dose per day



metronidazole 

500 mg per oral two times daily for seven days
if taking a single dose, 2 gm oral should be the dose per day



dequalinium 

Insert 1 tablet into the vagina daily at night before bedtime for 6 days
Pause the treatment during menstruation and continue afterward



 

secnidazole 

Age: >12 years:

1

packet

Orally 

daily



 

Media Gallary

References

https://www.ncbi.nlm.nih.gov/books/NBK459216/

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Bacterial Vaginosis

Updated : December 12, 2022




Bacterial vaginosis is a disorder brought on by an overabundance of the natural flora in the vagina. The most typical clinical sign of this is an increase in fishy-smelling vaginal secretions. Typically, the discharge is thin and can be either white or grey in color.

Women who have been confirmed with vaginosis are more likely to contract other STIs, & expectant women are more likely to give birth before their due date.

The majority of genital infections in females of reproductive age, known as bacterial vaginosis, are thought to affect 5 to 70 percent of females. It’s interesting to note that, globally, this illness is shown to be least common in Europe and Asia and most common in several regions of Africa.

Around 30 percent of women in the USA between the ages of 14 and 49 are afflicted; however, rates vary among ethnic groups and are particularly prevalent among non-white women (32 percent Mexican Americans, 51 percent African Americans).

According to epidemiological research, women who have had several sex partners, are alone, started having sex at a young age, work as female sex workers, and regularly touch are more likely to report having bacterial vaginosis.

The disequilibrium of the naturally existing microbial composition that results in bacterial vaginosis is defined by changes in both the predominant kind of bacteria involved and an increase in the overall number of bacteria involved. The typical vaginal microbiome is dominated by Lactobacilli genera. A decrease in Lactobacilli, in general, is linked to bacterial vaginosis.

Gardnerella vaginalis is assumed to be the primary cause of the majority of bacterial vaginosis infestations; however, the exact cause is still unknown. Gardnerella vaginalis forms a biofilm that enables other opportunistic microbes to proliferate inside the vagina. The connection between BV and a higher risk of developing STIs is based on the fact that BV creates a window of opportunity for other genital bacteria to enter the upper reproductive tract.

In addition, BV causes an increase in the release of endotoxins that promote cytokine & prostaglandin synthesis in the vagina, as well as the accumulation of enzymes that hinder the ability of donor leukocytes to combat infection.

The function of transmissibility in bacterial vaginosis is still not well understood, despite the fact that it is not regarded as an infection transmitted sexually. Bacterial vaginosis appears to be caused by an imbalance in the normal microbe flora of the vagina brought on by the transmission of bacteria between people during sexual activity.

This illness is typically brought on by an excess of anaerobes and maybe a decrease in the usual Lactobacilli that normally produce hydrogen peroxide. Gardnerella vaginalis can spread between sex partners when mucosa comes into close contact or when shared sex devices are used.

Gardnerella vaginitis was the name given to bacterial vaginosis in the past because it was thought that these bacteria were to blame for the illness. The term “bacterial vaginosis,” which is more recent, emphasizes the possibility that a variety of alternative bacteria that naturally exist in the vagina may proliferate excessively and result in illness.

clindamycin 

300

mg

orally

twice a day

7

days



secnidazole 

1

packet

Orally 

daily



tinidazole 

2g/day orally for two days or 1g orally every day for five days



metronidazole 

500 mg per oral two times daily for seven days
if taking a single dose, 2 gm oral should be the dose per day



metronidazole 

500 mg per oral two times daily for seven days
if taking a single dose, 2 gm oral should be the dose per day



dequalinium 

Insert 1 tablet into the vagina daily at night before bedtime for 6 days
Pause the treatment during menstruation and continue afterward



secnidazole 

Age: >12 years:

1

packet

Orally 

daily



https://www.ncbi.nlm.nih.gov/books/NBK459216/

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