A 23 year old woman presents with a foul smelling vaginal discharge and mild vulvar itching for three weeks, which worsened during menstruation. There was no lower abdominal pain or fever. She engages in unprotected sex with a single, regular partner. Their last encounter was a week ago. She is currently on the combined oral contraceptive pill (COCP). Her medical history is unremarkable.
Application of potassium hydroxide (KOH) yields an amine odor.
Microscopy shows motile flagellated organisms and multiple leukocytes. No clue cells are seen.
The CT scan of the abdomen appears normal.
The gram stain shows multiple flagellated organisms and leukocytes. No intracellular diplococci are noted.