Gardnerella vaginalis and its clinical syndrome

The Gardnerella vaginalis syndrome is a well defined but benign condition characterized by a smelly vaginal discharge of pH greater than 5.0. It is not associated with inflammation. It often occurs in association with cervical infections. The microscopic appearance of the discharge is typical and diagnostic. The wet mount shows "clue cells" and "rafts" (floating clumps of small bacilli) and the Gram stain has the "pepper on salt" pattern of masses of small gram-variable bacilli. The amine test is an additional diagnostic aid. Cultures are useful but not necessary for diagnosis. The treatment of choice is oral metronidazole 400 mg twice daily for five days.