Group B Strep in the vagina is only starting to get more recognition, with the main symptoms being itching and burning, with discharge. It is almost always diagnosed as bacterial vaginosis, yeast infections, or trichomoniasis (a sexually transmitted infection). This leaves many women without relief, untested (because many physicians don’t believe or understand it affects the vagina). It is often dismissed as a transient bug despite evidence to the contrary.

Symptoms

  • Itching
  • Burning
  • Discharge – clear or white
  • Red hot labia
  • Possible fissuring of labia
  • Inflammation

Streptococcus agalactiae is the gram-positive bacterium responsible for the vaginal and vulvar inflammation and discharge, but it also causes lactobacilli to become more rare in the vagina and cause the pH to become more alkaline (which isn’t good). There are multiple strains being discovered, and that is one reason why it is hard to identify. In addition, not all testing gear is created equal and can’t necessarily easily pick up these sorts of bacteria.

About Group B Strep (GBS)

This infection typically affects newborn babies and can result in life-threatening infections that cause septicaemia, meningitis and pneumonia. It can affect adults, and typically causes diseases on the skin, in soft tissues, the urinary tract, and involving the bones and joints.

This bacteria is known to provoke an inflammatory reaction in the vagina, decrease lactobacilli populations, and causes very red, hot labia, perhaps even with vaginal fissures.

Treatment

The treatment of group B Strep vaginitis is a combination of topical lactobacilli plus antibiotics. Partners should be treated also.

Identification failure and misdiagnosing

Some isolates of GBS are assumed to be uncommon – under 10 per cent – which may be underestimated due to misdiagnosis. Variants of GBS can exist and behave slightly differently, and all women with these symptoms should be screened for group B antigens. Visual identification is exceedingly difficult, and chromogenic media may not be able to identify these phenotypes. (According to one study1, Liofilchem Chromatic StreptoB worked well.)

 

  1. Int J Clin Exp Pathol. 2013; 6(8): 1693–1695. Streptococcus agalactiae vaginitis: nonhemolytic variant on the Liofilchem Chromatic Strepto B Vincenzo Savini, Roberta Marrollo, Marianna D’Antonio, Claudio D’Amario, Paolo Fazii, Domenico D’Antonio

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