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 is a sign of

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Bacterial vaginosis, characterized by a foul-smelling discharge, can be diagnosed microscopically or clinically. The discharge is primarily sloughed epithelial cells, many of which are completely 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 BV. Although Gardnerella 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 BV. A clinical diagnosis of BV is best made using three or more of the following criteria: homogeneous, gray discharge; clue cells seen on wet mount or Gram stain; an amine or fishy odor elicited by the addition of a drop of 10% KOH to the discharge on a slide or on the speculum; and a pH greater than 4.5.

Large Amounts of Epithelial Cells, Many of Which Are Covered