Bacterial vaginosis can be diagnosed by detecting which cytologic finding?

• A. Clue cells
• B. Pseudohyphae
• C. Budding yeasts
• D. Gram-positive cocci

Answer: (A)

Clue cells are the hallmark cytologic finding for bacterial vaginosis. They are vaginal epithelial cells whose borders look smeared or coated because numerous bacteria cling to their surfaces, giving a stippled, granular edge on microscopy. This heavy bacterial adherence is characteristic of the altered vaginal flora in BV, commonly involving Gardnerella vaginalis and other anaerobes, and is best seen on a Gram stain or saline wet mount. When you spot these coated epithelial cells, BV is strongly supported.

Pseudohyphae and budding yeasts point to a yeast infection, such as Candida, not BV, while Gram-positive cocci do not define BV and can appear in a variety of other vaginal flora contexts.