What are clue cells indicative of?

Clue cells are sloughed epithelial cells that have a distinct appearance characterized by their stippled or "clue-like" surface due to the presence of bacteria, particularly Gardnerella vaginalis. These cells are commonly identified in a wet mount examination of vaginal discharge and are considered a hallmark of bacterial vaginosis, which is often associated with an overgrowth of Gardnerella vaginalis and a decrease in the normal lactobacillus flora.

The presence of clue cells is significant as it points towards an imbalance in the vaginal microbiome, rather than a viral infection or a condition unrelated to the vaginal flora, like nephrotic syndrome. Additionally, while normal vaginal flora can include various microorganisms, the identification of clue cells specifically signifies an issue rather than normal findings. Therefore, the presence of clue cells serves as an important diagnostic indicator of a Gardnerella vaginalis infection.