PID:Understanding-Bacterial-Vaginosis.pptx

Overview of Bacterial Vaginosis (BV)
Bacterial Vaginosis (BV) is a common vaginal infection caused by an imbalance in the natural vaginal microbiota, where harmful bacteria outgrow beneficial lactobacilli. Unlike STIs, BV is not strictly sexually transmitted, but sexual activity and douching can increase the risk.

Key Features:
Symptoms: Thin, grayish-white vaginal discharge, fishy odor, vaginal itching, and burning during urination (some cases are asymptomatic).
Causes & Risk Factors: Douching, new or multiple sexual partners, lack of lactobacilli, and use of intrauterine devices (IUDs).
Complications: Increased risk of STIs (including HIV), pelvic inflammatory disease (PID), and pregnancy complications like preterm birth.
Diagnosis: Clinical symptoms, vaginal pH >4.5, presence of clue cells, and positive whiff test (fishy odor when mixed with potassium hydroxide).
Treatment: Metronidazole or Clindamycin (oral or vaginal gel).
Prevention: Avoid douching, maintain healthy vaginal flora, and use protection during sex.

1. Understanding Bacterial Vaginosis Bacterial vaginosis (BV) is a common vaginal infection. It affects women of childbearing age. It results from an imbalance of vaginal flora. The infection causes abnormal discharge and discomfort. by Agboola Michael

2. What is Bacterial Vaginosis? Normal Vaginal Flora A healthy vagina has a balance of bacteria, primarily Lactobacillus spp. , which produce hydrogen peroxide and H+(PH < 4.5) to keep harmful bacteria in check. BV Disruption BV occurs when the balance is disrupted, leading to a proliferation of anaerobic bacteria like Gardnerella vaginalis, Mycoplasma hominis, and Mobiluncus .

3. What Causes Bacterial Vaginosis? Disrupted Flora BV occurs when the vaginal environment changes. pH Imbalance A rise in vaginal pH contributes to BV. Anaerobic Bacteria Increased anaerobic bacteria, like Gardnerella vaginalis .

4. Risk Factors Multiple Partners Having new or multiple sexual partners. Douching Vaginal douching disrupts natural flora. Unidentified Factors Other unknown elements play a role.

5. BV: Recognizing the Symptoms Fishy Odor The discharge often has a distinct fishy smell, especially after intercourse. Increased Discharge BV often presents with increased vaginal discharge that is thin and white. No Itching Unlike yeast infections, BV usually doesn't cause itching or irritation.

6. The Connection Between BV and Odor 1 Anaerobic Bacteria The anaerobic bacteria in BV produce amines, chemicals that release a fishy smell. 2 Decarboxylation These bacteria break down amino acids like lysine and arginine, producing amines. 3 Fishy Smell The amines, like cadaverine and putrescine, are responsible for the characteristic fishy odor of BV.

7. Potential Complications Pre-term Delivery Infertility Increased STI risk Pelvic Inflammatory Disease (PID)

8. Differential Diagnoses Mixed Vaginitis Trichomoniasis Atrophic Vaginitis Candidal Vaginitis

9. Diagnosis: Amsel Criteria 1 Clue Cells Presence of clue cells on a vaginal smear. 2 pH Level Vaginal pH greater than 4.5. 3 Positive Amine Positive amine test of discharge.

10. Understanding Clue Cells Clue cells are vaginal epithelial cells. They are covered with anaerobic bacteria. This is a key sign of bacterial vaginosis.

11. Treatment Options Oral Metronidazole 1 Intravaginal Clindamycin 2 Intravaginal Metronidazole 3

12. Treatment of BV Treatment Options BV is typically treated with antibiotics. Recommended regimen: Metronidazole 400 mg orally, every 12 hours for 7 days Alternative regimen: Metronidazole 2 g orally, as a single dose Metronidazole 0.75% gel 5 g intravaginally, twice daily for 7 days Recommended regimen for pregnant women: Metronidazole 200 mg orally, every 8 hours for 7 days or 2g as a single dose if trreatment is imperative in the first trimester of pregnancy.

13. Treatment options for BV First-Line option Effective Substituites Metronidazole 400 mg or 500 mg, orally, twice daily for 7 days Clindamycin 300 mg, orally, twice daily for 7 days or Metronidazole 2 grams, orally, single dose Metronidazole 200 mg or 250 mg, orally, 3 times a day for 7 days or Metronidazole gel 0.75%, one full applicator (5 grams) intravaginally, twice a day for 7 days or Clindamycin 300 mg, orally, twice daily for 7 days

14. Key Takeaways BV is a common vaginal infection with identifiable causes. Early diagnosis can help prevent complications. Effective treatments are available for BV.