Case of a Girl with Vaginal Discharge Who Has Sex with Boys
Vaginal discharge is common among adolescent females. Physiologic leukorrhea is a benign condition which produces a clear, odorless vaginal discharge with no associated symptoms. The underlying etiology of discharge can be narrowed based on the clinical history and findings on speculum exam and laboratory evaluation. The nucleic acid amplification test (NAAT) is the most sensitive test to diagnose chlamydia, gonorrhea, or trichomonas infections and can be performed on noninvasive specimens like urine or a self-collected vaginal swab. Sexually active adolescent females under 25 years of age, including asymptomatic individuals, should be screened via NAAT for chlamydia and gonorrhea annually. Individuals infected with a sexually transmitted infection (STI) should be treated according to the Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines, 2015. Sexual partners exposed to an STI should receive empiric treatment. Expedited partner therapy (EPT) is one method of partner treatment (where legally permitted), though it is not ideal as partners may not get tested for other concomitant asymptomatic infections.
KeywordsVaginal discharge Mucopurulent cervicitis Trichomoniasis Chlamydia Gonorrhea Bacterial vaginosis Vulvovaginal candidiasis
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