A positive 'whiff test' or amine test indicates which condition?

The 'whiff test' or amine test is a clinical procedure used to identify bacterial vaginosis (BV). When a vaginal discharge is mixed with potassium hydroxide (KOH), the release of a fishy odor indicates the presence of aminic compounds associated with the overgrowth of bacteria, particularly Gardnerella vaginalis, which disrupts the normal flora of the vagina.

In cases of bacterial vaginosis, the characteristic discharge is often thin, gray or white, and has a strong fish-like smell, especially after intercourse or menstrual cycle, which aligns with the positive result of the whiff test. This test is a quick and effective way to suggest the diagnosis of bacterial vaginosis in a clinical setting.

Other conditions such as atrophic vaginitis, chronic lichen sclerosus, and recurrent candidiasis do not typically produce this particular odor or result from the whiff test, as they involve different underlying mechanisms or infections. Thus, a positive whiff test specifically points to bacterial vaginosis as the correct condition.