Which wet-mount result confirms a preliminary diagnosis of bacterial vaginosis?

The choice that confirms a preliminary diagnosis of bacterial vaginosis involves identifying squamous epithelial cells that present with a stippling appearance and indistinct borders, along with the absence of lactobacillus rods and a high number of white blood cells. In bacterial vaginosis, there is typically a dysbiosis of the vaginal flora, where the normally predominant lactobacilli are diminished, leading to an increased prevalence of other bacteria.

The stippling appearance and indistinct borders of squamous epithelial cells are characteristic findings in bacterial vaginosis. This morphology indicates cellular alteration due to the imbalance of vaginal flora. Additionally, elevated white blood cell counts suggest an inflammatory response, which can occur due to the overwhelming presence of potentially pathogenic organisms associated with bacterial vaginosis.

In contrast, the other results reflect different conditions: abundant lactobacilli are typically seen in a healthy vaginal microbiome, which is not consistent with bacterial vaginosis; organisms resembling white blood cells with flagella indicate possible trichomoniasis; and hyphae and spores suggest a fungal infection, such as candidiasis. Thus, the specific combination of cell morphology, the lack of lactobacilli, and the presence of white blood cells effectively confirms bacterial vaginos