Bacterial Vaginosis vs Candidal Vulvovaginitis
Bacterial Vaginosis and Candidal Vulvovaginitis are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Bacterial Vaginosis vs Candidal Vulvovaginitis at a glance
- Bacterial Vaginosis: Dysbiosis of vaginal flora — loss of lactobacilli with overgrowth of anaerobes; thin gray discharge with fishy odor.
- Candidal Vulvovaginitis: Yeast infection of the vulva/vagina — thick white discharge, intense pruritus, normal pH.
Keep comparing — start your free trial
You've used your 2 free previews. Create your free account to see the full Bacterial Vaginosis vs Candidal Vulvovaginitis comparison — plus all 514 diagnosis outlines, 6,400+ board-style questions, and an AI tutor. Your 7-day free trial includes everything, no credit card required.
Side-by-side comparison
| Feature | Bacterial Vaginosis | Candidal Vulvovaginitis |
|---|---|---|
| At a glance | Dysbiosis of vaginal flora — loss of lactobacilli with overgrowth of anaerobes; thin gray discharge with fishy odor. | Yeast infection of the vulva/vagina — thick white discharge, intense pruritus, normal pH. |
| Classic presentation | Reproductive-age woman with thin gray discharge, fishy odor after intercourse, vaginal pH >4.5, clue cells on wet mount, positive whiff test.; Thin, gray-white homogeneous vaginal discharge; Fishy odor, often worse after intercourse or menses; Minimal or no pruritus or inflammation (distinguishes from candidiasis/trichomoniasis); ~50%… | Woman after antibiotic use with severe vulvar itching, vulvar erythema, thick curd-like discharge, normal pH, and yeast/pseudohyphae on KOH prep.; Intense vulvar and vaginal pruritus (hallmark); Burning, soreness, irritation; External dysuria (urine contacting inflamed vulva); Dyspareunia; Thick white 'cottage cheese' discharge —… |
| Workup / key labs | Amsel criteria (3 of 4): (1) thin homogeneous gray-white discharge, (2) vaginal pH >4.5, (3) positive whiff test with KOH, (4) clue cells on saline wet mount. Nugent score (gram-stain based) is research/lab gold standard.; Vaginal pH (normal 3.8-4.5; BV >4.5); Wet mount: clue cells (epithelial cells coated with bacteria obscuring… | Vaginal pH normal (<4.5) — important distinguishing feature; 10% KOH wet mount: budding yeast, pseudohyphae (C. albicans) or budding yeast without pseudohyphae (C. glabrata); Negative whiff test; Culture if recurrent, severe, or atypical (identifies non-albicans species and resistance); Fasting glucose or A1c if recurrent — screen for… |
| First-line treatment | Metronidazole 500 mg PO BID × 7 days; Metronidazole 0.75% vaginal gel 5 g intravaginally daily × 5 days; Clindamycin 2% vaginal cream 5 g intravaginally at bedtime × 7 days | Uncomplicated: fluconazole 150 mg PO × 1 dose; Topical azole alternatives × 1-7 days: clotrimazole, miconazole, terconazole, tioconazole (available OTC); Patient symptom relief usually within 24-48 hours |
Drill Bacterial Vaginosis vs Candidal Vulvovaginitis questions on FirstPassPA
Turn this comparison into retention. 6,400+ board-style questions with an AI tutor that explains every answer — free to start, no card required.
Start studying free → Try today's free questionEducational use only. This outline is a study aid for PA students and is not medical advice or a substitute for clinical judgment. FirstPassPA is an independent study tool and is not affiliated with, endorsed by, or sponsored by NCCPA or PAEA. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants; End of Rotation™ is a program of the Physician Assistant Education Association.