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Unresolved cervicitisFrom: Susan Mcniel (smcniel@u.washington.edu)Mon Jun 30 15:13:38 1997
29 yo woman presents with "months" of fierce vulvar pruritis, occ. dyspareunia. Has seen approx 3 providers including obgyn, FP PA, FP. Has used multiple treatments of the "zoles" (both prescribed and self Rx), doxy (both she and her husband have been treated), now on clindamycin cream intravag. On Loestrin 1.5/30 X 7 years. Last PAP 3/97 - normal, no abnormal PAP hx. 1 1/2 yrs ago had resistant cystitis, saw urologist, had VCUG which was nl. but was placed on prophylactic antibx (Macrodantin? she did not remember) which she stopped taking 2 mos ago. On exam labia is inflamed and dry, vag walls dry,deep pink. Cx c ectopy & covered c adherent thick white DC. No CMT. Ut: NSSC, NT. Nml adnexa. Wet mt- neg X3, rare bacteria, copious WBC. Neg CT, GC. Couple of thoughts: 1. Cytolytic vaginitis 2. High progestational OC is related to cervicitis, so change to less progestational OC. 3. Mucopurulent DC prob due to ectopy and refer for cryo. (I am referring but would like input from this group-what would you do?) 4. Other? TIA Susan McNiel, MN, ARNP
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