A 19-year-old woman comes to the physician because of pelvic pain and vaginal discharge for the past 3 weeks. She has no history of serious medical illness and takes no medications. Her temperature is 39°C (102.2°F). Pelvic examination shows pain with movement of the cervix and mucopurulent cervical discharge. Culture of the discharge shows thin, elongated, gram-positive bacilli in an acute-angle branching pattern. Which of the following is the most appropriate pharmacotherapy for this patient?

Question

A 19-year-old woman comes to the physician because of pelvic pain and vaginal discharge for the past 3 weeks. She has no history of serious medical illness and takes no medications. Her temperature is 39°C (102.2°F). Pelvic examination shows pain with movement of the cervix and mucopurulent cervical discharge. Culture of the discharge shows thin, elongated, gram-positive bacilli in an acute-angle branching pattern.  Which of the following is the most appropriate pharmacotherapy for this patient?

Quizplus · Accepted Answer

Eductional Objective: Actinomyces is an anaerobic, gram-positive bacillus with acute-angle branching.  It can colonize intrauterine devices (IUDs) and may cause pelvic inflammatory disease (eg, fever, abdominal pain, mucopurulent cervical discharge).  Treatment is with IUD removal and penicillin.

A 19-Year-Old Woman Comes to the Physician Because of Pelvic