Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The Nugent Scoring System for Bacterial Vaginosis is a clinical calculator used in the diagnosis of bacterial vaginosis (BV), a common vaginal infection in women of reproductive age. This scoring system is based on the microscopic examination of vaginal fluid, specifically the presence and quantity of Lactobacillus morphotypes, Gardnerella vaginalis morphotypes, and curved gram-variable rods. The score ranges from 0 to 10, with a score of 7 or higher indicating bacterial vaginosis. 

The Nugent Scoring System is primarily used in research settings due to its complexity and the need for a trained microscopist. It is considered the gold standard for diagnosing BV, but it may not be suitable for use in primary care or resource-limited settings where microscopy is not readily available. There are no specific exclusion criteria for its use, but it may be less accurate in postmenopausal women due to changes in vaginal flora.

Nugent scoring system for bacterial vaginosis

# Criteria
 ## Lactobacillus morphotypes
A. None (+4)
B. < 1 (+3)
C. 1-4 (+2)
D. 5-30 (+1)
E. >= 30 (+0)
## Gardnerella and Bacteroides species
F. None (+0)
G. < 1 (+1)
H. 1-4 (+2)
I. 5-30 (+3)
J. >= 30 (+4)
## Curved Gram-negative rods
K. None (+0)
L. < 1 (+1)
M. 1-4 (+1)
N. 5-30 (+2)
O. >= 30 (+2)

# Conditions
- score <= 3
- score <= 6
- score >= 7
- score == 0

Calculator Name: Amsel's Diagnostic Criteria for Bacterial Vaginosis

Amsel's Diagnostic Criteria for Bacterial Vaginosis is a clinical tool used to diagnose bacterial vaginosis (BV), a common vaginal infection in women of reproductive age. This calculator applies to women presenting with symptoms of vaginal discharge, discomfort, or odor. 

The clinical utility of Amsel's criteria is to aid in the diagnosis of bacterial vaginosis, which can help guide appropriate treatment and prevent potential complications such as pelvic inflammatory disease, adverse pregnancy outcomes, and increased susceptibility to sexually transmitted infections.

The criteria include the presence of at least three of the following: thin, white, yellow, homogeneous discharge; clue cells on microscopy; pH of vaginal fluid >4.5; and a fishy odor of vaginal discharge before or after addition of 10% KOH (whiff test). 

There are no specific exclusion criteria for the use of Amsel's criteria. However, it should be noted that this diagnostic tool may not be as accurate in postmenopausal women, as the vaginal environment naturally changes with age and may affect the results. Additionally, it should not be used in isolation but in conjunction with other clinical findings and tests.

Amsel's diagnostic criteria for bacterial vaginosis

# Criteria
 A. Homogeneous vaginal discharge (+1)
B. Fishy odor when potassium hydroxide solution is added to vaginal secretions (+1)
C. Clue cells on wet mount microscopy (+1)
D. Vaginal pH > 4.5 (+1)

# Conditions
- score >= 3
- score <= 2
- score == 0

Bacterial vaginosis

Background

Overview

Guidelines

Key sources

Screening and diagnosis

Medical management

Specific circumstances

Follow-up and surveillance