Bacterial vaginosis Amsel criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]


For clinicians, BV is a common vaginal condition characterized by at least three of the following four Amsel criteria include thin, gray/white discharge, malodorous “fishy” discharge upon adding 10 % potassium hydroxide, high vaginal pH (>4.5), and identification of clue cells.[1][2]

Amsel criteria

For clinicians, BV is characterized by at least three of the following four Amsel criteria:[1][2]

  1. Thin, gray/white vaginal discharge
  2. Malodorous “fishy” discharge upon adding 10% potassium hydroxide
  3. High vaginal pH (>4.5)
  4. Identification of vaginal epithelial cells heavily coated with bacteria (clue cells)
“Clue cells” are epithelial cells that have had bacteria adhere to their surface - Source:


  1. 1.0 1.1 Center for Disease Control and prevention. Mortality and morbidity weekly reports. Sexually transmitted disease treatment guideline. (2015) Accessed on October 20, 2016
  2. 2.0 2.1 Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK (1983) Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med 74 (1):14-22. PMID: 6600371

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