It is now considered to represent an overgrowth of aerobic and anaerobic bacteria. There is some controversy regarding the possible contributing role of sexual partners and intrauterine devices in this infection. The patient's chief complaint will be a malodorous discharge, in contrast to the extreme itching of candidiasis. This discharge is characterized as being homogenous and gray with a fishy odor. On occasion, it may be frothy.
Clue cells are epithelial cells with a stippled or granulated appearance.
The treatment of choice for bacterial vaginosis is metronidazole. Patients taking metronidazole must be cautioned against drinking alcohol during and 48 hours after treatment because of the well-established disulfiramlike reaction. Treatment of the sexual partner is not necessary unless he has balanitis. Trichomonas vaginalis, an anaerobic protozoan that is found in the genitourinary tract, can infect both men and women. It is considered an STD that often goes untreated because it is an infection that is largely asymptomatic.