A 35-year-old woman comes to the physician because of a history of malodorous vaginal discharge. She has no pain or pruritus. Menses occur at regular 27-day intervals and last 5 days. Her last menstrual period was 2 weeks ago. She is sexually active with two male partners and uses a diaphragm for contraception. She had a normal Pap smear 3 months ago. She has no history of serious illness and takes no medications. Her temperature is 37.3°C (99°F), pulse is 75/min, and blood pressure is 115/75 mm Hg. Pelvic examination shows malodorous, gray vaginal discharge. The pH of the discharge is 5.0. Application of potassium hydroxide solution to the discharge yields a strong odor. Which of the following is the best treatment option for this patient?

Question

A 35-year-old woman comes to the physician because of a history of malodorous vaginal discharge. She has no pain or pruritus. Menses occur at regular 27-day intervals and last 5 days. Her last menstrual period was 2 weeks ago. She is sexually active with two male partners and uses a diaphragm for contraception. She had a normal Pap smear 3 months ago. She has no history of serious illness and takes no medications. Her temperature is 37.3°C (99°F), pulse is 75/min, and blood pressure is 115/75 mm Hg. Pelvic examination shows malodorous, gray vaginal discharge. The pH of the discharge is 5.0. Application of potassium hydroxide solution to the discharge yields a strong odor.  Which of the following is the best treatment option for this patient?

Quizplus · Accepted Answer

Eductional Objective: Bacterial vaginosis causes a thin, gray or clear, malodorous discharge from overgrowth of anaerobes (eg, Gardnerella vaginalis) and a loss of lactobacilli in the vaginal flora.  Diagnosis is confirmed by the presence of clue cells and a positive amine whiff test with potassium hydroxide.  Treatment is with clindamycin or metronidazole.

A 35-Year-Old Woman Comes to the Physician Because of a History