4.54.5 (5-6)Gold standard investigation Gram stain: on gram staining Nugent scoring is done-The Nugent score is calculated by assessing the presence of lactobacillus (Gram +ve rods-scored as 0 to 4), Gardnerella vaginalis (scored as 0 to 4) and mobilincus (Gram variable rods-scored as 0-2) A score of >=7 is consistent with bacterial vaginosisCulture on sabouraud'smedium or NickersonmediumCulture on --Feinberg Whittington media or Diamond mediaT/t = Non pregnant femalesMetronidazole (500 mg BD x 7 days) orClindamycinAzole group of antifungals Like fluconazole/miconazole which can be applied topically or given orally (150 mg, single dose)Metronidazole(2 gm single dose oral)Pregnancy = DOCMetronidazole (250 mg TDS x 7 days)To be avoided in first trimesterTopical azole antifungalsTo be avoided in first trimesterMetronidazole(250 mg TDS x 7 days)Simultaneous treatment of male partnerNot needed as BV is not an STDIf partner has symptoms then treatment neededAlways done as Trichomonas vaginalis is an STDMicroscopic findingsSaline wet prep'Clue cells', bacterial clumps10% KOH solution wet prep Pseudohyphae and bud seenSaline wet prepMotile pear-shaped trichomonadsVulvovaginitis">