How to differentiate bacterial vaginosis

The most common symptoms of bacterial vaginosis are excessive vaginal discharge, burning and itching of the vulva and vagina, exogenous dysuria, and erythema of the vulva (fungal or candidal vulvar bacterial vaginosis). Typical vaginal discharge is curd-like or lumpy, the vaginal mucosa is highly red and swollen, and white thrush-like patches can be seen attached and easily peeled off. Underneath is the eroded base of the damaged mucosa, or shallow ulcers are formed. In severe cases, ecchymoses may remain. So, how to differentiate bacterial vaginosis?

1. For bacterial vaginosis, take a smear of the secretions and examine it under a Gram staining microscope. Common pathogens can be found, but no fungi or Trichomonas are present.

2. For fungal vaginitis, take secretions for smear and use Gram stain. Under the microscope, you can find groups of Gram-positive, densely stained oval spores, or pseudohyphae and budding cells connected in chains or branches. The most reliable method is to perform fungal culture examination.

3. For trichomoniasis, take the secretion and mix it with a small amount of warm saline dripped on a glass slide, and examine it under a microscope. Active vaginal Trichomonas can be seen. If Trichomonas cannot be found in a special case, the culture method can be used instead, which has a high accuracy.

4. The discharge examination of senile vaginitis should be distinguished from that of trichomonas and fungal vaginitis. Pay attention to the size and shape of the cervix and uterus, the source of bleeding and the results of vaginal cytology. If necessary, perform a cervical or endometrial biopsy to rule out the possibility of uterine cancer.