Which of the following women is most likely to have bacterial vaginosis?

Bacterial vaginosis (BV) is characterized by an overgrowth of certain types of bacteria in the vagina, leading to a distinct set of symptoms. A key symptom of BV is a "fishy" vaginal odor, which is often more noticeable after sexual intercourse or during menstruation. This odor occurs due to the production of amines from the bacteria associated with BV.

The age of the woman in this scenario aligns with the typical demographic at greater risk for BV, particularly among younger, sexually active women. In this context, the 26-year-old woman with the "fishy" vaginal odor is indicative of bacterial vaginosis and represents the classic presentation of the condition.

While other symptoms like itching and burning, as seen in the 56-year-old woman, or a white, curdy discharge in the 34-year-old could suggest other conditions such as yeast infections or vulvovaginal candidiasis, they do not align with the primary symptoms of BV. Similarly, the presence of motile organisms in the 22-year-old suggests a different condition, such as trichomoniasis, which is clinically distinct from BV. Thus, the 26-year-old woman's symptoms best reflect the characteristics associated with bacterial vaginosis.