VAGINAL LACTOBACILLOSIS

OBJECTIVES: Our purpose was to study a cyclic condition characterized by vaginal discharge and discomfort occurring 7 to 1 0 days before men ses and associated with the occurrence of long serpiginous rodlike org anisms, 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. Sp ecies of lactobacilli isolated from some of the women were identified and the antibiotic susceptibility was determined. Recent episodes of v aginitis 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 an tifungal therapy. Anaerobic lactobacilli were isolated from 97% of the vaginosis patients and from 40% of the controls. The average length o f the organisms seen was 60 mum in the patients and 10 mum in the comp arison group. Amoxicillin and clavulanate potassium proved to be an ef fective therapy symptomatically and resulted in disappearance of the e xtremely long organisms in vaginal smears. CONCLUSIONS: Lactobacilli v aginosis is associated with extremely long lactobacilli. The cause of this morphologic transformation is unknown. The condition can be effec tively treated with antibiotics.