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Bacterial vaginosis — DRCOG MCQ

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EasyContraception and Sexual HealthBacterial vaginosisDRCOG

A 20-year-old woman has thin grey vaginal discharge with a fishy smell after intercourse. She has no pelvic pain, vulval soreness or fever. Vaginal pH is elevated and microscopy shows clue cells. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Bacterial vaginosis

Fishy-smelling grey discharge, raised pH and clue cells are characteristic of bacterial vaginosis. Candida more often causes vulval itch with thick discharge and normal pH. The pearl is that BV is associated with altered vaginal flora and is not managed like an upper genital tract infection.

Reference: BASHH Bacterial vaginosis guideline; NICE CKS