Supposed BV but normal cultures?

Hello. I have been dealing with a supposed BV infection for almost 2yrs now. I have seen about 6 different doctors and been on over 15 medications and nothing has made it go away. I'm not sure what's going on.

In 2009 I had a UTI for the first time. I put it off for a few days because I didn't know. Once I got a fever, chills and kidney pain, I went straight to the dr. He said I had a really bad UTI and gave me Cipro for 5-7 days. I had developed a white discharge after the cipro and went back to the dr. He said urine was fine, but I have BV and a slight yeast infection. He gave me about 4 different courses of medications, none of which worked. Then I saw a gyno. He also said BV, gave me some more flagyl, clindamycin, doxycyclin, keflex, z-pack and everything else that I can't remember, nothing worked.

My pH was normal, but when I went to the doctor last week, it was a bit elevated for the first time. He sent out another culture, and still, nothing. He saw lots of clue cells under the microscope. I also used to have tons of WBC, but the doctor said it was looking better and although I had some, there wasn't nearly as many.

I take acidophilus capsules+vitamin D supplements (I have a deficiency). I can hardly tolerate exams with the speculum because it hurts to have anything inserted. I still have discharge with a sour smell.I've been negative for all STDs. I've abstained from sex since this started. I had a physical and I appear to be a healthy individual aside from the vit d deficiency. I exercise and eat well most of the time. I do have a gluten allergy, not sure if it is related and I think I may be lactose intolerant.

How can I have bacterial vaginitis but nothing grows out on cultures?A general aerobic and anaerobic culture have all been done, aside from whatever else the doctor usually does.From what I have read, several different kind of bacteria live in the vagina, so wouldn't something grow out?

Thank you in advance for any advice or any information.

[Elaine Brown, MD]

Hi!
I've had a similar question so many times that I'm beginning to think this is a "syndrome".  The story almost always starts with a UTI and ends with a vaginal discharge that won't quit.

One thing that I know--antibiotics won't help, and in fact may have caused the problem in the first place.  You are correct that there are supposed to be bacteria in the vagina--in particular, the "good bacteria" lactobacillus.  I always recommend trying to re-establish a healthy population with probiotics or yogurt.  Once the good bacteria are happy, they can compete with the "bad bacteria" and keep them under control.

I usually also recommend a single treatment for yeast with diflucan--if there is any evidence of yeast on the wet mount.


Finally, I usually find that its best to avoid all antibiotics and also topical preparations such as over the counter yeast treatments.  Sometimes these can make the condition worse by causing dermatitis.  Oral contraceptives also don't seem to help. Sometimes a dermatologist can shed some light on the subject.

This condition takes quite awhile to improve, and it can be difficult to be patient!

I hope this is of some help!
Dr B