Bacterial Vaginosis Differential Diagnoses

Updated: Jan 28, 2022
  • Author: Philippe H Girerd, MD; Chief Editor: Michel E Rivlin, MD  more...
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Diagnostic Considerations

Important considerations

For patients presenting with atypical clinical features of bacterial vaginosis, the clinician must be aware of the possibility of a coinfection, such as vaginal candidiasis, trichomoniasis, infection with C trachomatis or N gonorrhoeae, HSV infection, or an alternative diagnosis.

Provide patients at risk of HIV with HIV counseling and testing.

Special concerns

No adequate and well-controlled human trials evaluating teratogenicity of clindamycin or metronidazole in pregnant women have been performed.

The use of the cream formulation of clindamycin may result in preterm birth.

Several clinical trials using both preparations in pregnancy have been conducted. The use of metronidazole after the first trimester is considered within the standard of care.

Differential Diagnoses