Case 5

A 25-year-old female presents with an abnormal, whitish vaginal discharge with a fishy odor for the past 10 days. She reports a history of condomless oral/vaginal sex with four male partners in the past year. She is currently in a relationship with a new male partner. The patient has a hormonal intrauterine device for contraception and takes sertraline for a history of anxiety/depression. She denies any history of fevers, chills, rashes, genital lesions, dysuria, hematuria or abnormal vaginal bleeding. About six months ago during her routine annual visit with her gynecology provider, she was negative for gonorrhea and chlamydia. Her male partner is asymptomatic. Speculum exam reveals a moderate amount of malodorous, whitish vaginal discharge without visible cervical mucus. Bimanual exam reveals no cervical motion tenderness, no uterine or adnexal tenderness, and no enlargement.

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