• • complex interplay:

  • decrease lactobacilli

  • decrease h2O2 production

  • increase pH

  • Overgrowth of BV associated bacteria

    • Garnerella vaginalis

      • mucoplasma hominis…

      • Bacteroides

Transmission

• not consdiered sexually transmitted infection

Symptoms

• Gardnerella found 50% healthy women

• women often asymptomatic

• not usually necessary to treat unless symptoms presnet or invasive procedure planned

• malodorous (Fish) grey/white vaginal dsicharge

• only sometimes causes irritatioon and itch

Testing:

• Swabs high vagina

• gram stain

first line

• metronidazole 400mg bd ofr 7/7

• metronidaozle 2g stat if adherence issue

  • hgiher rates of relapse

• treatment of male sexual partners not usually necessary