Whiff test is positive in

Bacterial vaginosis (BV) is an alteration of normal vaginal bacterial flora that results in the loss of hydrogen peroxide-producing lactobacilli and an overgrowth of predominantly anaerobic bacteria. Diagnosis A fishy vaginal odor, which is paicularly noticeable following coitus, and vaginal discharge are present.Vaginal secretions are gray and thinly coat the vaginal walls. The pH of these secretions is higher than 4.5 (usually 4.7 to 5.7). Microscopy of the vaginal secretions reveals an increased number of clue cells, and leukocytes are conspicuously absent. In advanced cases of BV, more than 20% of the epithelial cells are clue cells.The addition of KOH to the vaginal secretions (the "whiff" test) releases a fishy, amine-like odor. Treatment Metronidazole, an antibiotic with excellent activity against anaerobes but poor activity against lactobacilli, is the drug of choice for the treatment of BV. A dose of 500 mg administered orally twice a day for 7 days should be used. Ref: Berek and Novak's Gynecology; 15th edition; Chapter 18