What characteristic findings on a Gram stain smear suggest a diagnosis of Gardnerella vaginalis?

A diagnosis of Gardnerella vaginalis is often associated with several characteristic findings on a Gram stain smear that provide valuable clinical insight.

Pleomorphic gram-variable bacilli are a hallmark of Gardnerella vaginalis, which means the bacteria can appear in different shapes and sizes. This variability in Gram staining is key to identifying the organism, as it does not consistently retain the crystal violet stain used during the Gram staining process.

Additionally, the presence of clue cells is significant. Clue cells are vaginal epithelial cells that have been coated with bacteria, resulting in a stippled appearance. Their presence is a diagnostic indicator of bacterial vaginosis, a condition commonly associated with Gardnerella vaginalis infection.

Finally, finding many squamous epithelial cells on the smear can also support the diagnosis. Elevated numbers of these cells are common in cases of bacterial vaginosis, where the normal vaginal flora balance is disturbed.

Considering that all these findings can contribute to recognizing Gardnerella vaginalis, the comprehensive nature of having pleomorphic gram-variable bacilli, numerous squamous epithelial cells, and clue cells justifies the conclusion that all of these findings together strengthen the diagnosis.