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March 13, 1981

Postoperative Vaginal Discharge-Reply

Author Affiliations

Mount Sinai Hospital New York

JAMA. 1981;245(10):1026. doi:10.1001/jama.1981.03310350016010

In Reply.—  I wish to thank Dr Handsfield for his important comments.The description was "examination of the cervix" was "within normal limits." Nevertheless, if the white mucus vaginal discharge requiring the daily use of a tampon for 18 months in fact came from the endocervical canal, if it was mucopurulent without trichomonads and with a negative gonorrhea culture, then it might be caused by Chlamydia, especially if the patient's asymptomatic husband had nongonococcal urethritis.The diagnostic problem is complex because (1) it may be that most infected women with endocervical Chlamydia are asymptomatic1; (2) when Chlamydia causes clinical infection of the cervix it is variable and not distinctive; (3) there may be a purulent endocervical discharge not caused by Chlamydia; and (4) Chlamydia often coexists with other sexually transmitted diseases. Furthermore, the actual diagnosis requires tissue culture facilities not generally available.Though I agree with the recommendations, if