The clinical signs and symptoms of Gardnerella-associated vaginosis.

Gardnerella-associated vaginosis (Hemophilus vaginalis vaginitis, nonspecific vaginitis) is the most common cause of vaginal discharge and odor. The clinical spectrum of this infection varies from total lack of symptoms to obvious odor and profuse vaginal discharge. The diagnosis of this syndrome can be made when a woman presents with a homogenous grey-white discharge that emits a fishy odor when a drop of 10% potassium hydroxide is mixed with a drop of vaginal discharge on a glass slide. The pH of this secretion is typically in the range of 5.0-5.5 as determined by indicator paper. The diagnosis is further confirmed when a microscopic examination of the discharge mixed with normal saline shows a virtual pure culture of tiny bacteria many of which are found clinging to vaginal epithelial cells forming the so-called "clue cells". Cultures to isolate Gardnerella vaginalis are unnecessary in clinical practice.