Both yeast infections and bacterial vaginosis are vaginal infections and are common causes of vaginal discharge, but the two infections and medical conditions are not the same, and they require different treatments.

What is Yeast infection?

75% of women get at least one yeast infection during their life time. This is caused by overgrowth of natural yeast in the vagina and is known as Candidal vaginitis. The infection causes heavy cottage cheese like discharge and causes itching.

A vaginal yeast infection is a fungal infection that results in itching, heavy discharge, swelling around vagina and irritation. Vaginal yeast infection is also called vaginal candidiasis and affects up to three out of four women. Many women suffer twice or even more. Although a vaginal yeast infection is not transmitted sexually, yet one can spread the fungus through mouth or the genital contact. There are several treatments and medications that can cure vaginal yeast infections.

What is Bacterial Vaginosis?

It is a mild infection of the vagina. It is normally a mild problem that vanishes by itself after few days. However, it could lead to some serious health conditions, if not treated. Vagina has lactobacilli bacteria that has the tendency to keep other harmful bacteria at a distance. However, when the vagina is invaded by anaerobic bacteria, they kill off lactobacilli bacteria resulting in heavy vaginal discharge, burning and itching. The discharge could have a fishy odour, especially after being exposed to anything that could potentially increase body pH, such as semen or menstrual fluid. It is diagnosed by doing a pelvic exam and by taking a sample of the vaginal discharge. It is more common in women who are sexually very active as it is often transmitted through sexual intercourse. The risk of getting this infection is higher if you have more than one sexual partners and if you douche. If you have this infection when you are pregnant, it can cause miscarriage, preterm delivery and even uterine infection.

Difference between Yeast infection and Bacterial Vaginosis

Etiology

Yeast infection

The infection is caused by Candida species known as candida albicans.

Bacterial Vaginosis

Infection is caused by Gardnerella vaginalis, Mobiluncus species, Trichomonas vaginalis, Mycoplasma hominis and Urea plasma.

Pathophysiology

Yeast infection

The infection takes place inside the mouth, intestines, vagina and on the skin.

Bacterial Vaginosis

It is a synergistic infection involving not only Gardnerella vaginalis but several anaerobic bacteria as well.

Common symptoms

Yeast infection

Itching, Soreness, redness, rash, pain during intercourse. Whitish gray, watery and clumpy vaginal discharge is also a tell-tale symptom.

Bacterial Vaginosis

Heavy discharge (cloudy, bloody, yellow or green) vaginal pain and burning, abnormal consistency of vaginal fluid. The vaginal discharge and odour are often more noticeable after sexual intercourse.

Treatment

Yeast infection

Prescription antifungal agents. Common medications include; Butoconazole, Flucanozole (Diflucan), Itraconazole, Miconazole (Lotrimin), Monistat, Terconazole (Terazol). Possible treatments for extreme or complicated yeast infections include, 14-day cream or ointment or even suppository vaginal treatment.

Bacterial Vaginosis

Prescription antibiotic agents. Common medications include; Clindamycin, Tinidazole, Metronidazole

Vaginal discharge

Yeast infection

Vaginal discharge is curdy white, Cottage cheese like and sometimes increased.

Bacterial Vaginosis

Vaginal discharge may be increased in case of bacterial infection. It is white, thin, homogenous and grey coloured adherent.

Vaginal pH

Yeast infection

Vaginal pH is > 4.5 usually.

Bacterial Vaginosis

Vaginal pH is > 4.5.

KOH prep

Yeast infection

Pseudohyphae seen

Bacterial Vaginosis

Positive Whiff test

Amine odour

Yeast infection

Odour is virtually non-existent.

Bacterial Vaginosis

Fishy unpleasant odour is present

Soreness

Yeast infection

Very sore

Bacterial Vaginosis

Soreness is absent

Consistence

Yeast infection

Cottage cheese like.

Bacterial Vaginosis

Milky or creamy and thin viscosity.

Wet mount test

Yeast infection

Yeast buds or spores or hyphae can be seen. Wet mount examination reveals budding yeast and/or Pseudo hyphae. Here also WBC’s are seen.

Bacterial Vaginosis

On wet preparation of vaginal discharge, White blood cells are present and stippled epithelial cells support a diagnosis of bacterial vaginosis.

Risk factors

Yeast infection

Physiological – Pregnancy, infancy

Hematological – AIDS, Cellular immune deficiency, Leukemia, Aplastic Anemia, Lymphoma.

Iatrogenic – Antibiotics, Oral Contraceptives, Chemotherapy.

Uncontrolled diabetes or using oral birth control or estrogen hormone therapy. Douching, antibiotics, vaginal sprays, or steroid therapies and a weak immunity system also maximises the risk of contracting a yeast infection.

Bacterial Vaginosis

Increased number of sexual partners, Cigarette smoking, douching, Lack of condom use, Intrauterine device etc.

Examinations

Yeast infection

Physical examination

• Thick and white discharge adhering to walls of vagina.
• Vulvar and vaginal erythema
• Fissures
• Edema

Bacterial Vaginosis

Physical examination

• Appearance of tissue
• Discharge with no colour
• Abnormal odour
• Homogenous discharge adhered to walls of vagina

Summary  of Difference between Yeast Infection and Bacterial Vaginosis

The points of difference between Yeast Infection and Bacterial Vaginosis have been summarized below in tabular form:

Yeast infection Vs.  Bacterial Vaginosis

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