Patient's question:
Meaning itchy and uncomfortable for half a yearDoctor's answer:
Disease Analysis: The etiology of bacterial vaginosis involves the Gardnerella genus, a single-species genus. It is a newly discovered genus. Gardnerella is a Gram-negative rod, some of which can vary into coccobacilli. The bacterial cells are small, with rounded ends, no capsule, and no flagella. They are nutritionally anaerobic, with some being obligately anaerobic. The cell length is 0.3-0.45 μm, width 0.1-0.2 μm, and the shape is smaller than that of Lactobacillus, showing pleomorphism. The optimal pH for culture is 6.0-6.5, and they cannot grow at a pH below 4.0. They do not produce amines, nor do they produce catalase or oxidase. The H2O2 inhibition test is positive. The main sugar fermentation product is acetic acid. Under electron microscopy, the thin layers of the cell wall show layered structures and contain lipopolysaccharides. The normal vaginal flora is mostly composed of various facultative anaerobic Lactobacillus species, such as Lactobacillus and Granulicatella, which produce lactic acid, hydrogen peroxide, and other important factors in regulating the vaginal flora. In patients with bacterial vaginosis, these genera are absent or present in only small amounts in the vagina.Guidelines for Treating Bacterial Vaginosis:
1. Metronidazole 250-500 mg, twice daily, for 7 days. Avoid alcohol for 2 days during medication. Not recommended for pregnant women.
2. Tinidazole 1.0 g, once daily, for 10-15 days.
3. Tetracycline 500 mg, four times daily, for 7 days.
4. Clindamycin 300 mg, twice daily, for 7 days.
5. Amoxicillin 0.5 g, four times daily, for 7 days.
6. A 1% lactic acid or acetic acid solution can be used for vaginal irrigation to restore the normal physiological environment and inhibit bacterial growth.
7. Lactobacillus therapy and lactobacillus preparations are used abroad. Lactobacillus therapy is primarily used for vaginal irrigation and the preparation of suppositories placed in the vagina.