Which symptom is most indicative of bacterial vaginosis rather than candidiasis?

• A. Fishy odour with thin discharge
• B. Curd-like discharge
• C. Severe itching
• D. Swollen labia

Answer: (A)

The main idea here is distinguishing bacterial vaginosis from candidiasis by how they typically present in symptoms. Bacterial vaginosis tends to cause a thin, grayish discharge accompanied by a fishy odor. That fishy smell is produced by volatile amines from the overgrowth of certain bacteria in the vaginal flora. The discharge is usually not thick, and itching is mild or absent.

In contrast, candidiasis (yeast infection) usually presents with thick, white, curd-like discharge and prominent itching and irritation of the vulva and vaginal area. Swelling can occur with infections in general, but it’s not the defining feature of BV.

So the finding of a fishy odor with a thin discharge is the most specific indicator that points toward bacterial vaginosis rather than candidiasis.