Large amounts of epithelial cells, many of which are covered by tiny gram-variable rods and coccobacilli, and the absence of inflammatory cells in vaginal discharge are signs of:
a. pelvic inflammatory disease (PID).
b. bartholinitis.
c. cervicitis.
d. bacterial vaginosis.
D
Bacterial vaginosis, characterized by a foul-smelling discharge, can be microscopically or clini-cally diagnosed. The discharge is primarily sloughed epithelial cells, many of which are com-pletely covered by tiny, gram-variable rods and coccobacilli. These cells are called clue cells. The absence of inflammatory cells in the vaginal discharge is another sign of bacterial vaginosis. Although G. vaginalis has been historically associated with the syndrome and can be cultured on a human blood bilayer plate, culture is not recommended for diagnosis of bacterial vaginosis. A clinical diagnosis is best made using three or more of the following criteria: homogeneous, gray discharge; clue cells observed on wet mount or Gram stain; an amine or fishy odor elicited by the addition of a drop of 10% potassium hydroxide (KOH) to the discharge on a slide or on the spe-culum; and a pH greater than 4.5.
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