Vaginal lactobacillosis

Abstract

Objectives: Our purpose was to study a cyclic condition characterized by vaginal discharge and discomfort occurring 7 to 10 days before menses and associated with the occurrence of long serpiginous rodlike organisms, visible in wet mount preparations.

Study design: Thirty-seven patients and 30 controls were studied prospectively. The vaginal flora was analyzed, including isolation of anaerobic bacteria and fungi. Species of lactobacilli isolated from some of the women were identified and the antibiotic susceptibility was determined. Recent episodes of vaginitis and therapy were recorded.

Results: Ninety-two percent of the patients had a history of recent episodes of vaginosis lasting for an average of 22.2 months, and 57% had received triazole or imidazole antifungal therapy. Anaerobic lactobacilli were isolated from 97% of the vaginosis patients and from 40% of the controls. The average length of the organism seen was 60 microns in the patients and 10 microns in the comparison group. Amoxicillin and clavulanate potassium proved to be an effective therapy symptomatically and resulted in disappearance of the extremely long organisms in vaginal smears.

Conclusions: Lactobacilli vaginosis is associated with extremely long lactobacilli. The cause of this morphologic transformation is unknown. The condition can be effectively treated with antibiotics.