 Welcome back to our meds smarter lecture series where we're taking a smarter approach to preparing future physician Before we get started if you'll take just a quick minute and click that like button and also Subscribe and turn the bell on so that you'll be notified when we post new videos Let's continue on in our discussion of gram-negative organisms and discuss gardener Ella Gardener Ella is a pleomorphic gram variable rod Involved in bacterial vaginosis. So what does Pleomorphic mean so pleomorphic in this context means that it's going to be irregular in regards to its shape Gardener Ella is gram variable meaning that it can have some aspects that are gram positive and gram negative It does have a gram positive cell wall Ultra structure, but it doesn't have that classic cell wall lipo polysaccharide It presents as a gray vaginal discharge with a fishy smell and there's no pain associated with it This is something that's associated with sexual activity. However, it's not an STD or a sexually transmitted disease It's characterized by overgrowth of certain anaerobic bacteria in the vagina because we have a decrease in the lactobacilli Which is usually that normal Bacteria that's found that helps keep everything working normally So what are we going to see with gardener Ella as far as a neuromigroscope? Well, this is a picture of what you're going to see and what you're seeing here are clue cells These are clue cells, which are vaginal epithelial cells that are covered in gardener Ella They kind of have a stippled appearance to them Along their outer margin as you can see in that picture there a Diagnostic procedure to determine if gardener Ella is present is going to be the amine with test and what you're doing here is we're going to mix the Sample that we receive from the vagina that has our gray vaginal discharge We're going to mix it with the 10% KOH prep and that's going to enhance that fishy odor So if you get a stronger odor associated with that, that's going to be a positive amine with test and to treat this We're going to use metronitazole or clindamycin So a way to remember gardener Ella and all the things associated with it That's important is going to be that I don't have a clue. So clue cells Why I smell fish because that's going to be the smell that we see that odor in the vagina garden So garden being gardener Ella If you found this material helpful for your studying Please like and consider subscribing to the channel also share this video so that more people can benefit from it like you have