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Other Causes of Vaginal Discharge or Vaginitis In the ulcerative vaginitis associated with staphylococcal toxic shock syndrome, Staphylococcus aureus should be promptly identified in vaginal fluid by Gram's stain and by culture. In desquamative inflammatory vaginitis, smears of vaginal fluid reveal neutrophils, massive vaginal epithelial-cell exfoliation with increased numbers of parabasal cells, and gram-positive cocci; this syndrome may respond to treatment with 2% clindamycin cream. | Chapter 124. Sexually Transmitted Infections Overview and Clinical Approach Part 11 Other Causes of Vaginal Discharge or Vaginitis In the ulcerative vaginitis associated with staphylococcal toxic shock syndrome Staphylococcus aureus should be promptly identified in vaginal fluid by Gram s stain and by culture. In desquamative inflammatory vaginitis smears of vaginal fluid reveal neutrophils massive vaginal epithelial-cell exfoliation with increased numbers of parabasal cells and gram-positive cocci this syndrome may respond to treatment with 2 clindamycin cream. Additional causes of vaginitis and vulvovaginal symptoms include retained foreign bodies e.g. tampons cervical caps vaginal spermicides vaginal antiseptic preparations or douches vaginal epithelial atrophy in postmenopausal women or during prolonged breastfeeding in the postpartum period allergic reactions to latex condoms vaginal aphthae associated with HIV infection or Behẹet s syndrome and vestibulitis a poorly understood syndrome . Mucopurulent Cervicitis Mucopurulent cervicitis MPC refers to inflammation of the columnar epithelium and subepithelium of the endocervix and of any contiguous columnar epithelium that lies exposed in an ectopic position on the exocervix. MPC in women represents the silent partner of urethritis in men being equally common and often caused by the same agents N. gonorrhoeae C. trachomatis or as shown by case-control studies M. genitalium however MPC is more difficult than urethritis to recognize. As the most common manifestation of these serious bacterial infections in women MPC can be a harbinger or sign of upper genital tract infection also known as pelvic inflammatory disease PID see below . In pregnant women MPC can lead to obstetric complications. In a prospective study in Seattle of 167 consecutive patients with MPC defined on the basis of yellow endocervical mucopus or 30 polymorphonuclear leukocytes PMNs 1000x microscopic field who were seen at STD clinics during the .