Bacterial Vaginosis Scored Gram Stain

Test Mnemonic


CPT Codes

  • 87205 - QTY (1)




  • Bacterial Vaginitis
  • Gram Stain
  • Vaginitis
  • Vaginitis Exam
  • Vaginosis
  • Vaginosis Exam


  • A scored microscopic examination for normal versus abnormal vaginal bacteria

Performing Laboratory

Cleveland Clinic Laboratories

Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
UnspecifiedVaginalSwab AmbientCulturette swab in non-nutritive transport medium (eg, Amies or Stuart)

Minimum Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions


Environmental Condition Description
Ambient1 week
Refrigerated1 week

Days Performed

Sun - Sat

Turnaround Time

1 day


Name Description
Gram Stain 

Reference Range

BV Gram Stain
Sex Age From Age To Type Range Range Unit
       Negative for Bacterial Vaginosis 

Special Info

Determination of a score for the relative amounts of microbial morphologies observed in a Gram stain of vaginal fluid is the definitive method for diagnosing bacterial vaginosis. A predominance of medium to large gram positive bacilli suggestive of lactobacilli (score 0-3) is consistent with normal vaginal flora. A predominance of gram-negative or gram variable rods suggestive of Gardnerella vaginalis, Mobiluncus, and Bacteroides species (score 7-10) is consistent with bacterial vaginosis. An intermediate score (4-6) suggests a transition from normal vaginal flora.

Clinical Info

Clinical criteria for the diagnosis of bacterial vaginosis (BV) include 1) thin, homogeneous vaginal discharge, 2) clue cells (vaginal squamous epithelial cells coated with bacteria that mask the cell border), 3) increased vaginal pH (>4.5), and 4) fishy odor of vaginal excretions enhanced by adding KOH. Women with BV may report no signs or symptoms. BV is not fully understood, but the condition is associated with a reduction in normal Lactobacillus flora and an increase in other bacteria including Gardnerella vaginalis, Mobiluncus and Bacteroides. BV has been associated with increased susceptibility to sexually transmitted diseases (HIV, HSV, gonorrhea, chlamydia) and obstetric complications (miscarriage, preterm birth, postpartum endometritis). If it is unclear that the patient has BV and additional tests for Trichomonas and candidiasis are being ordered (i.e. all three tests), then the recommended test is the Affirm (VAGDNA).