A client presents to the out-client clinic complaining of gray discharge that has a fishy odor. The ...

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The diagnosis of bacterial vaginosis is made when at least three of the following signs or symptoms are present: abnormal gray discharge, vaginal pH above 4.5 (usually 5.06.0), positive fishy odor of vaginal discharge on addition of 10 potassium hydroxide, and appearance of characteristic clue cells on wet-mount microscopic studies. T. vaginalis is an anaerobic protozoan that is shaped like a turnip and has three or four anterior flagella. Chlamydia exists in two morphologically distinct forms during its unique lifea small infectious elementary body and a large noninfectious reticulate body. The diagnosis of syphilis can be made rapidly by dark-field microscopic examination of the exudate from skin lesions. However, the test is reliable only when a specimen with actively motile T. pallidum is examined immediately by a trained microscopist. It does, however, evoke a humoral immune response and production of antibodies that provide the basis for serologic tests.