Nugent Score (BV Gram-stain scoring)

Nugent Score Calculator (BV)

Nugent Score Calculator (Bacterial Vaginosis)

Enter Gram-stain semi-quant results (0, 1+, 2+, 3+, 4+) to calculate the Nugent score (0–10) and interpretation.

More lactobacilli → lower score.
More BV-associated rods → higher score.
Adds 0–2 points (not 0–4).
Total score:

Enter values and tap Calculate.

Breakdown will appear here.
Clinical note: This calculator supports Nugent scoring from Gram-stained vaginal smears. Use alongside clinical assessment and local guidance. Not for patient self-diagnosis.

The Nugent score is a standardized microscope scoring system used to help diagnose bacterial vaginosis (BV) from a Gram-stained vaginal smear. Instead of relying only on symptoms, it grades the balance of vaginal bacteria by looking at three bacterial “morphotypes” (shapes/Gram reactions) under oil immersion and assigning points based on how many are seen per high-power field.

What it measures (the three morphotypes)

On the stained smear, the microscopist semi-quantifies:

  1. Lactobacillus morphotypes (large Gram-positive rods): typically dominate in a healthy, lactobacillus-predominant microbiota. Fewer lactobacilli increases the score.
  2. Gardnerella/Bacteroides morphotypes (small Gram-variable/negative rods): BV-associated flora; more of these increases the score.
  3. Curved Gram-variable rods (Mobiluncus morphotypes): when present in higher quantities, they add additional points.

Each component is converted to points (0–4 for the first two, 0–2 for curved rods), then added to produce a total score from 0 to 10.

How to interpret the total score

A commonly used interpretation is:

  • 0–3: Lactobacillus-predominant (BV unlikely)
  • 4–6: Intermediate microbiota
  • 7–10: Consistent with BV

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