E-ISSN 2146-9369 | ISSN 2146-3158
 

Review Article


Pathogenesis and specific diagnosis of bacterial vaginosis, vaginitis, and flagellate/coinfection in women: An expert review

Christian Azubike Enwuru, Veronica Nkechi Enwuru.


Abstract
Bacterial vaginosis (BV), vaginitis, and flagellate or candida coinfections are common vaginal infections with distinct pathogeneses and diagnostic criteria. These conditions are often misdiagnosed because of overlapping symptoms. In establishing female genital health, the primary emphasis is on the microbiota and its effects on genital tissues. Early and specific diagnoses are essential for the prompt management of these conditions, which require distinct or combined therapies. Misdiagnosis increases morbidity, leads to complications, and occasionally results in mortality. This review aims to clarify terminology, highlight diagnostic distinctions, and promote accurate diagnosis and treatment of BV, vaginitis, and co-infections in women by peer health workers. A search was conducted using terms such as pathogens, symptoms, diagnosis, pathogenesis, and coinfections, with additional search combinations such as: Phrase searching, Boolean operators and wildcards, and transcribed through Google Scholar, PubMed, Scopus, JSTOR, CORE, books, and primary sources to evaluate the use and application of terms and case definitions for these conditions. Filters: English-language studies from the last 15 years, reviews, randomized controlled trials, observational studies, and case series published by professionals among women of reproductive age. We observed the following confusing terms: vaginitis (inflammation of the vagina, often caused by infections) and vaginosis (an imbalance in the vaginal microbiota without significant inflammation). Aerobic vaginitis (caused by aerobic bacteria and involves an inflammatory response) versus bacterial vaginitis (caused by an overgrowth of anaerobic bacteria and lacks significant inflammation). Understanding BV coinfections, which complicate diagnosis and prolong treatment, is becoming prominent. The misuse of medical terms and misdiagnosis of vaginal conditions, such as vaginitis, vaginosis, and coinfections with flagellates or fungi, could lead to harmful consequences. Coinfection involving bacteria, parasites, and Candida spp. may be described as the concurrent infection of a host by multiple
pathogen species that can be parasitic, symbiotic, or antagonistic among the pathogens and cause serious harm to the host. The global incidence and prevalence of such coinfections among women have not been thoroughly documented and therefore require further research.

Key words: Bacterial vaginosis; Virginitis; Aerobic-virginitis coinfection; Pathogenesis; Misdiagnosis and Terminologies.


 
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How to Cite this Article
Pubmed Style

Enwuru CA, Enwuru VN. Pathogenesis and specific diagnosis of bacterial vaginosis, vaginitis, and flagellate/coinfection in women: An expert review. J Microbiol Infect Dis. 2025; 15(4): 128-141. doi:10.5455/JMID.2025.v15.i4.1


Web Style

Enwuru CA, Enwuru VN. Pathogenesis and specific diagnosis of bacterial vaginosis, vaginitis, and flagellate/coinfection in women: An expert review. https://www.jmidonline.org/?mno=257330 [Access: October 10, 2025]. doi:10.5455/JMID.2025.v15.i4.1


AMA (American Medical Association) Style

Enwuru CA, Enwuru VN. Pathogenesis and specific diagnosis of bacterial vaginosis, vaginitis, and flagellate/coinfection in women: An expert review. J Microbiol Infect Dis. 2025; 15(4): 128-141. doi:10.5455/JMID.2025.v15.i4.1



Vancouver/ICMJE Style

Enwuru CA, Enwuru VN. Pathogenesis and specific diagnosis of bacterial vaginosis, vaginitis, and flagellate/coinfection in women: An expert review. J Microbiol Infect Dis. (2025), [cited October 10, 2025]; 15(4): 128-141. doi:10.5455/JMID.2025.v15.i4.1



Harvard Style

Enwuru, C. A. & Enwuru, . V. N. (2025) Pathogenesis and specific diagnosis of bacterial vaginosis, vaginitis, and flagellate/coinfection in women: An expert review. J Microbiol Infect Dis, 15 (4), 128-141. doi:10.5455/JMID.2025.v15.i4.1



Turabian Style

Enwuru, Christian Azubike, and Veronica Nkechi Enwuru. 2025. Pathogenesis and specific diagnosis of bacterial vaginosis, vaginitis, and flagellate/coinfection in women: An expert review. Journal of Microbiology and Infectious Diseases, 15 (4), 128-141. doi:10.5455/JMID.2025.v15.i4.1



Chicago Style

Enwuru, Christian Azubike, and Veronica Nkechi Enwuru. "Pathogenesis and specific diagnosis of bacterial vaginosis, vaginitis, and flagellate/coinfection in women: An expert review." Journal of Microbiology and Infectious Diseases 15 (2025), 128-141. doi:10.5455/JMID.2025.v15.i4.1



MLA (The Modern Language Association) Style

Enwuru, Christian Azubike, and Veronica Nkechi Enwuru. "Pathogenesis and specific diagnosis of bacterial vaginosis, vaginitis, and flagellate/coinfection in women: An expert review." Journal of Microbiology and Infectious Diseases 15.4 (2025), 128-141. Print. doi:10.5455/JMID.2025.v15.i4.1



APA (American Psychological Association) Style

Enwuru, C. A. & Enwuru, . V. N. (2025) Pathogenesis and specific diagnosis of bacterial vaginosis, vaginitis, and flagellate/coinfection in women: An expert review. Journal of Microbiology and Infectious Diseases, 15 (4), 128-141. doi:10.5455/JMID.2025.v15.i4.1