19 Apr Sandy is a 16 year old who comes in for complaints of vaginal itching and thick white discharge x3 days
Case Scenario 4: Sandy is a 16 year old who comes in for complaints of vaginal itching and thick white discharge x3 days. She also reports unprotected vaginal intercourse with a new consensual male partner in the past 2 weeks. She is not on any birth control.
What other relevant questions should you ask Sandy?
What diagnostic studies would you order today for Sandy?
What patient education is important to include for this patient?
Based of Sandy’s symptoms it is likely she has chlamydia, which is known as the one of the most reported sexually transmitted infections. Relevant questions to ask Sandy are, Did symptoms start suddenly or gradually? What is the color of the vaginal discharge? What odor do you encounter? Do you have any vaginal bleeding or burning? Any recent fever, pelvic pain or abdominal pain? How many sexual partners have you been involved with recently? Any history of STIs? Has any of your partners or partner reported similar signs and symptoms? Do you use protection during sexual intercourse? When was your last menstrual period? Have you been pregnant before? If so, how many? Do you have any medical problems? Are you currently taking any medications? Diagnostics to confirm diagnosis are nucleic acid amplification tests (NAATs). If test comes back positive, this will indicate the presence of chlamydia trachomatis and should be treated. Other tests that can be used to diagnose are direct immunofluorescence, enzyme immunoassay, nucleic acid hybridization tests and cell culture (Hamill, 2025).
Chlamydia initially starts off with no symptoms but can also do a lot of damage to the reproductive system, transmission entails vaginal, anal or oral sex with protection during intercourse with someone who has the infection, there treatment options for chlamydia are antibiotics such as doxycycline, azithromycin, levofloxacin, etc. (Hamill, 2025). It is important to educate Sandy to notify her sexual partner on the need to get tested treated accordingly, educate safe sex practices like use of condoms to prevent STIs and contraceptives to avoid unplanned pregnancies. Personal hygiene should also be emphasized.
Reference
Hamill, M. (2025, January 05). Epocrates Web. Genital tract chlamydia infection – Symptoms, Causes, Images, and Treatment Options. Retrieved April 15, 2026, from http://www.epocrates.com/online/diseases/52/genital-tract-chlamydia-infection#overview
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