Woman Cervical Motion Cell Wall Y/O Previous H/O

46 y/o ♀ → previous h/o STI comes to your urgent care and you suspect gonorrhea → culture which show lancet-shaped diplococci → prescribe ceftriaxone → woman returns four months later with ^c/_o pain below belly button which is confirmed with (+) cervical motion tenderness → explain

Ceftriaxone works on peptidoglycan cell wall on N.gonorrhea → will not work on C. trachomatis which has a cell wall but not one made of peptidoglycans) → pathogenesis is as follows → untreated chlamydia → ascending infx → PID → tuboovarian abscess → fallopian tubes scarring → infertility → proceed with treatment for co-infection of gonorrhea (ceftriaxone) and chlamydia (azithromycin/doxycycline) to cover BOTH bugs