Wet mount. A sample of vaginal discharge is mixed with a salt (normal saline) solution after placing it on a microscope slide. The prepared slide is examined to identify the bacteria present, to look for white blood cells that point to an infection, and to look for unusual cells called clue cells. The presence of clue cells is one sign f bacterial vaginosis.
Whiff test. Several drops of a potassium hydroxide (KOH) solution are added to a sample of vaginal discharge to find out whether a strong fishy odor is produced. A fishy odor on the whiff test suggests bacterial vaginosis.
Vaginal pH. The normal vaginal pH is 3.8 to 4.5. Bacterial vaginosis usually causes the vaginal pH to rise above 4.5.
Oligonucleotide probes. This test detects the genetic material (DNA) of bacterial vaginosis bacteria. Oligonucleotide probe testing is very accurate but is not routinely available in most labs.
The presence of clue cells, an increased vaginal pH, and a positive whiff test are enough evidence to treat for bacterial vaginosis.
Bacterial vaginosis may be found during a routine pelvic exam.