How do you approach a persistently positive Mycoplasma genitalium cervical swab PCR in a patient who has undergone multiple courses of the standard CDC-recommended therapy but continues to experience pelvic symptoms and vaginal discharge?  

This is a tough one. The first question is whether M. genitalium is in fact the cause of the problem. The second is what "pelvic symptoms" she has. Is a gynecologist involved? If suspicious for PID -- e.g., adnexal and/or uterine tenderness on bimanual exam -- the diagnosis should be confi...

With caution. Sorry, couldn't resist.