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Re: Bacterial vaginosisFrom: ainsron@msn.comThu Sep 14 13:06:11 2000
At Wed, 13 Sep 2000, freda seddon wrote: > >I need an opinion; >vaginal swab on multip at 30 wks with three year hx of vaginal discharge, >burning with urination and pruritis. Urine culture negative but large blood >on urine dip X 3 clinic visits. Discharge is pale grey/white. No odour, >monogamous, strict muslim. Microscopic report: pattern consistent with >bacterial vaginosis, culture, normal flora. > >What would you do? Dysuria and pruritus are not typical symptoms of bacterial vaginosis, neither is the lack of odor. Typical odor is strong amine/fishy smell, especially after KOH is added to the smear, but I often smell it as I'm introducing the speculum. What was the pH? Most authorities feel that a pH > 4.5 rules out bacterial vaginosis. Vaginal cultures are useless for diagnosis of bacterial vaginosis, the mere presence of Gardnerella on a culture does not make it the cause of vaginitis in a patient. Large amt of blood on urine dip stick is bothersome, is it vaginal contamination, is it from a kidney stone, does she have a bladder tumor...?
-- Ronald E. Ainsworth, MD
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