Bacterial vaginosis represents an anaerobic strep infection of the vagina producing an inflammatory, malodorous discharge. Simple cultures often grow gardnerella, but gardnerella is simply a marker and not the underlying issue.

BV can be identified by observing “clue cells” on the Pap smear. A finding of BV or gardnerella on an otherwise normal Pap smear in a patient without symptoms is of no consequence.

If the Pap shows inflammation sufficient to obscure the reading and the cytologist asks for an earlier-than-normal repeat Pap, many physicians will treat the patient with Flagyl before repeating the smear. Others will simply repeat the smear at a somewhat earlier-than-normal time.