Evaluation of vaginal discharge

Pelvic inflammatory disease

Patients with ascending infection (e.g., chlamydial and gonorrheal infection) may develop pelvic inflammatory disease, which can lead to tubal factor infertility, tubo-ovarian abscess, and ectopic pregnancy.[9]Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021. Jul 2021 [internet publication]. https://www.cdc.gov/std/treatment-guidelines/toc.htm

Empiric treatment with broad-spectrum antibiotics, which cover Chlamydia, gonorrhea, and anaerobes, is recommended in sexually active young women and other women at risk for sexually transmitted infections if:[9]Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021. Jul 2021 [internet publication]. https://www.cdc.gov/std/treatment-guidelines/toc.htm ​ 

• They are experiencing pelvic or lower abdominal pain

• No cause for the illness other than pelvic inflammatory disease can be identified

• One or more of the following three minimum clinical criteria are present on pelvic examination:

  • Cervical motion tenderness

  • Uterine tenderness

  • Adnexal tenderness

Signs of lower genitourinary tract infection (e.g., fever, mucopurulent discharge, presence of white blood cells on wet mount preparation) are not required for a diagnosis, but are confirmatory. Sexual partners should be treated.