Warning:

This document is being maintained for historical purposes, but is now out of date. To view current guidelines please visit:

• STD Treatment Guidelines   at http://www.cdc.gov/STD/treatment

---

1993 Sexually Transmitted Diseases Treatment Guidelines

09/24/1993

SUGGESTED CITATION
Centers for Disease Control and Prevention. 1993 Sexually
transmitted diseases treatment guidelines. MMWR 1993;42(No. RR-14):
{inclusive page numbers}.

CIO Responsible for this publication:
National Center for Prevention Services,
Division of Sexually Transmitted Diseases and HIV Prevention

Management of the Patient With Mucopurulent Cervicitis
     
     Mucopurulent cervicitis (MPC) is characterized by a yellow
endocervical exudate visible in the endocervical canal or in an
endocervical swab specimen. Some experts also make the diagnosis on
the basis of an increased number of polymorphonuclear leukocytes on
cervical Gram stain. The condition is asymptomatic among many
women, but some may experience an abnormal vaginal discharge and
abnormal vaginal bleeding (e.g., following intercourse). The
condition can be caused by C. trachomatis or N. gonorrhoeae,
although in most cases neither organism can be isolated. Patients
with MPC should have cervical specimens tested for C. trachomatis
and cultured for N. gonorrhoeae. MPC is not a sensitive predictor
of infection; however, most women with C. trachomatis or N.
gonorrhoeae do not have MPC.

Treatment
     The results of tests for C. trachomatis or N. gonorrhoeae
should determine the need for treatment, unless the likelihood of
infection with either organism is high or unless the patient is
unlikely to return for treatment. Treatment for MPC should include
the following:

--   Treatment for gonorrhea and chlamydia in patient populations
     with high prevalence of both infections, such as patients seen at
     many STD clinics.

--   Treatment for chlamydia only, if the prevalence of N.
     gonorrhoeae is low but the likelihood of chlamydia is substantial.

--   Await test results if the prevalence of both infections are
     low and if compliance with a recommendation for a return visit is
     likely.

Follow-Up
     Follow-up should be as recommended for the infections for
which the woman is being treated.

Management of Sex Partners
     Management of sex partners of women with MPC should be
appropriate for the STD (C. trachomatis or N. gonorrhoeae)
identified. Partners should be notified, examined, and treated on
the basis of test results. However, partners of patients who are
treated presumptively should receive the same treatment as the
index patient.

Special Considerations

HIV Infection -
     Persons with HIV infection and MPC should receive the same
treatment as patients without HIV infection.

---