Discharge Characteristic Comparison
Discharge texture is the first visual clue separating BV from candidiasis.
- Thin, gray: BV discharge (homogeneous coating)
- Thick, white: Yeast discharge (cottage-cheese clumps)
- Increased: BV volume (often malodorous)
- Prominent: Yeast itching (vulvar irritation)
Discharge appearance
Short placeholder note on discharge texture differences.
Odor Test (Whiff Test)
Adding KOH to BV discharge releases a distinct fishy amine odor.
- Positive: BV whiff test (fishy amine smell)
- Negative: Yeast whiff test (no amine odor)
- Amines: Cause (putrescine, cadaverine)
- 1 of 4: Amsel criteria role (clinical criterion)
Amine release mechanism
Short placeholder note on KOH amine volatilization.
pH Measurement Comparison
Vaginal pH above 4.5 strongly favors bacterial vaginosis over candidiasis.
- 3.8–4.5: Normal pH (lactobacilli dominant)
- >4.5: BV pH (often 5–6)
- ≤4.5: Yeast pH (usually normal)
- pH paper: Test method (lateral vaginal wall)
pH shift rationale
Short placeholder note on lactobacilli loss and pH rise.
Microscopy Findings
Wet mount microscopy distinguishes clue cells from budding yeast and hyphae.
- Clue cells: BV finding (stippled epithelial cells)
- Hyphae/buds: Yeast finding (pseudohyphae seen)
- Saline: BV prep (wet mount)
- 10% KOH: Yeast prep (lyses cells, keeps fungi)
Microscopic hallmark cells
Short placeholder note on clue cells versus hyphae.
Diagnostic Conclusion
Combining discharge, odor, pH, and microscopy yields the final differential.
- 3 of 4: Amsel criteria (confirms BV)
- KOH prep: Yeast confirm (hyphae visible)
- Metronidazole: BV treatment (or clindamycin)
- Azole antifungal: Yeast treatment (topical or oral)
Putting it together
Short placeholder note on final diagnostic synthesis.
Short placeholder: correlate all four criteria before treating.