Review Question - QID 106728

This woman presents with positive whiff test and microscopy demonstrating clue cells, suggestive of bacterial vaginosis (BV), caused by Gardnerella vagnialis.

The normal vagina is colonized by a mixture of bacteria. The pH of the vagina is usually acidic in part due to the presence of lactobacilli. However, changes in pH can lead to a change in bacterial flora. In particular, overgrowth of G. vaginalis, a gram negative rod, can lead to bacterial vaginosis (BV). Microscopy of a vaginal swab will show "clue cells," which are squamous cells with many bacteria adherent to them.

Figure A depicts clue cells. Illustration A shows a wet mount of a vaginal swab. The slide shows a clue cell in the lower left, with two normal appearing epithelial cells on the right for comparison. Illustration B depicts trichomonads, which can cause vaginitis. Illustration C depicts candida, which can also cause vaginitis.

Incorrect answers:
Answer 1: Trichomonas vaginalis is the causative agent in trichomonal vaginitis, which presents with greenish discharge, and significant pruritis.
Answer 2: Candida albicans is the causative agent in vulvovaginal candidiasis, which can present with thick, white, curd-like discharge.
Answer 3: Escherichia coli is a common causative agent of urinary tract infections (UTI).
Answer 5: Neisseria gonorrhoeae is the causative agent in gonoccocal urethritis and may lead to cervicitis or pelvic inflammatory disease (PID).