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Old 05-25-2011
apx85 apx85 is offline
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Some things I found on UptoDate:

1) BV is not due to a single organism. Instead it represents a complex change in the vaginal flora characterized by a reduction in concentration of the normally dominant hydrogen-peroxide producing lactobacilli and an increase in concentration of other organisms, especially anaerobic gram negative rods. The major bacteria detected are Gardnerella vaginalis, Prevotella species, Porphyromonas species, Bacteroides species, Peptostreptococcus species, Mycoplasma hominis, Ureaplasma urealyticum, and Mobiluncus species

2) The mechanism by which the floral imbalance occurs and the role of sexual activity in the pathogenesis of BV are not clear.

3) Hydrogen-peroxide producing lactobacilli appear to be important in preventing overgrowth of the anaerobes normally present in the vaginal flora. With the loss of lactobacilli, pH rises and massive overgrowth of vaginal anaerobes occurs. These anaerobes produce large amounts of proteolytic carboxylase enzymes, which break down vaginal peptides into a variety of amines that are volatile, malodorous, and associated with increased vaginal transudation and squamous epithelial cell exfoliation, resulting in the typical clinical features observed in patients with BV.

4) The rise in pH also facilitates adherence of G. vaginalis to the exfoliating epithelial cells, thereby creating the "clue cells" that are diagnostic of the disorder.

5) Risk factors for acquisition of BV include multiple or new sexual partners, douching, and cigarette smoking. Douching, but not other personal hygienic behaviors, appears to be casually associated with BV. Sexual activity is a risk factor for the condition; It is not clear, however, whether one type of sexual activity may be more important in the pathogenesis of infection than another. As an example, oral-genital sex may be a more important risk factor than penile intromission into the vagina
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