August 16, 2012

A 35 year old sexually promiscous woman

35 year old sexually promiscous woman has painful lower abdominal cramps, fever and increased vaginal discharge. A pelvic examination demonstrates adnexal tenderness. The most appropriate treament would include:

a) zidovudine (ZDV) plus lamivudine (3TC) plus IDV
b) intravenous Trimethoprim/Sulfamethoxazole
c) combination of ticarcillin and gentamicin
d) 1-time dose of metronidazole
e) IM ceftriaxone plus doxycycline

The correct answer is E

Distinguish pelvic inflammatory disease (PID) from simple cervicitis. Though the causative bacterial species are similar, outpatient PID should not be treated with single-dose oral agents but with IM ceftriaxone (250 mg) plus doxycycline for 14 days.

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