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Postoperative Vaginal Discharge

H. Hunter Handsfield, MD
JAMA. 1981;245(10):1026. doi:10.1001/jama.1981.03310350016009.
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To the Editor.—  The response by Albert Altchek, MD (243:1469, 1980), to the question "Postoperative Vaginal Discharge" was an excellent review of the etiology of vaginal discharge, except for failure to consider infectious cervicitis. Clinicians should recognize that sexually transmitted cervical infections apart from gonorrhea are common causes of increased vaginal discharge and that with a careful speculum examination and judicious use of a Gram-stained smear, it is possible to differentiate vaginal from cervical origin of the discharge.1Nongonococcal endocervicitis is the most frequent counterpart in women of nongonococcal urethritis in men. Apart from Neisseria gonorrhoeae, Chlamydia trachomatis is the bestdocumented cause of infectious cervicitis2,3; herpes simplex is an occasional cause, but herpetic cervicitis is rare in the absence of vulvar herpes lesions. Cultures for C trachomatis are available in some virology laboratories and university medical centers and in a few local and state health departments. Even without


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