Final answer:
Vaginal pH above 4.5, decreased lactobacilli, and granular/stippled epithelial cells suggest bacterial vaginosis (BV). Treatment usually involves antibiotics to restore the balance of vaginal microbiota.
Step-by-step explanation:
Vaginal pH above 4.5 and a decrease in lactobacilli, along with the presence of granular and stippled epithelial cells with indistinct borders on a wet prep, suggest a condition called bacterial vaginosis (BV). BV is caused by an overgrowth of bacteria, particularly Gardnerella vaginalis. When lactobacilli decrease, G. vaginalis flourishes and attaches to vaginal epithelial cells, forming a thick protective biofilm. This can lead to symptoms such as abnormal discharge and odor. Treatment usually involves antibiotics, such as metronidazole or clindamycin, to restore the balance of vaginal microbiota.