Most women who are infected with BV manifest no overt symptoms of this infec­tion (Centers for Disease Control, 2009i). However, when present, the most common symptom of bacterial vaginosis in women is a foul-smelling, thin discharge that resem­bles flour paste in consistency. The discharge is usually gray or white, but it can also be yellow or green. The disagreeable odor, often noticed first by an infected woman’s sexual partner, is typically described as fishy or musty. This smell may be particularly noticeable after coitus because the alkaline seminal fluid reacts with the bacteria, caus­ing the release of the chemicals that produce the smell. A small number of infected women experience irritation of the genital tissues and a mild burning sensation during urination. Recent evidence suggests a link between bacterial vaginosis and both PID and adverse pregnancy outcomes, including premature rupture of the amniotic sac and preterm labor (Centers for Disease Control, 2009i; Marrazzo et al., 2011).

Having a BV infection can both increase a woman’s susceptibility to HIV infection if she is exposed to this virus and increase the probability that an HIV-infected woman will transmit HIV to her sexual partner(s) (Centers for Disease Control, 2009i).

Men may also harbor the infectious organisms that cause BV, often without mani­festing detectable symptoms. However, some infected males develop inflammation of the foreskin and glans of the penis, urethritis (inflammation of the urethral tube), and cystitis (bladder infection).

Treatment

For many years the treatment of choice for bacterial vaginosis has been metronidazole (Flagyl) taken by mouth for 7 days. However, recent research indicates that intravaginal application of topical metronidazole gel or clindamycin cream is as effective as oral met­ronidazole (Workowski et al., 2010). Studies indicate that there is little or no proven benefit in treating male sex partners of women diagnosed with BV (Centers for Disease Control, 2009i). Female sex partners should be evaluated and treated if necessary.

candidiasis

An inflammatory infection of the vagi­nal tissues caused by the yeastlike fungus Candida albicans.