Which diagnosis is indicated by a normal saline mixture showing clue cells?

The presence of clue cells in a normal saline mixture is highly indicative of bacterial vaginosis (BV). Clue cells are vaginal epithelial cells that have a characteristic stippled appearance due to their coating with bacteria. This phenomenon is a hallmark of bacterial vaginosis, which is caused by an imbalance in the normal flora of the vagina, leading to an overgrowth of certain bacteria, particularly Gardnerella vaginalis.

In diagnosing bacterial vaginosis, the clinical criteria often include the presence of clue cells, a homogeneous discharge, and a fishy odor, especially after intercourse. The normal saline solution helps visualize these clue cells under a microscope, further supporting the diagnosis of BV.

Other conditions mentioned, such as candidiasis, trichomonas, and gonorrhea, have different associated characteristics. For example, candidiasis typically presents with a thick, white, curd-like discharge and may show yeast forms on microscopy, not clue cells. Trichomonas usually presents with a frothy, yellow-green discharge and motile trichomonads on wet mount examination. Gonorrhea might be identified through gram stain or other cultures rather than by the presence of clue cells in saline.

Therefore, the identification of clue cells in a vaginal discharge sample points specifically