A 20-year-old female presents with a one-week history of vaginal pain. She has been sexually active with 3 partners over the last 6 months and only uses condoms occasionally. She has never been pregnant. She has been using Motrin for the pain and tried sitz baths three times a day for a few days without any improvement.

On exam, vital signs reveal:
- Heart rate: 70 beats per minute
- Respiratory rate: 20 breaths per minute
- Blood pressure: 90/60 mmHg
- Temperature: 100.2 degrees Fahrenheit

Examination of her heart, lungs, and abdomen is within normal limits. Examination of her external genitalia reveals a 3 cm erythematous mass in the posterior labia between the vestibule and labia majora at the 7 o'clock position. There is foul green discharge from the mass. Speculum exam is within normal limits.

In addition to screening for STIs, what is the best course of action?

A. Treatment with a course of antibiotics effective against mixed flora
B. Hot compresses and sitz baths 3 times a day
C. An oral antiviral medication
D. Liquid nitrogen

The best course of action for a patient with signs of infection and possible STI is a course of antibiotics effective against mixed flora and screening for STIs. Treatment of sexual partners is also necessary to prevent reinfection.Hence, the correct option is A. Treatment with a course of antibiotics effective against mixed flora.

The patient presenting with vaginal pain and a foul green discharge from an erythematous mass suggests an infection, possibly sexually transmitted infection (STI) or a bacterial infection. Given the symptoms and history, the best course of action would be to treat with a course of antibiotics effective against mixed flora. It is also essential to screen for STIs to determine the exact cause of the infection and treat any potential pathogens appropriately.

The patient's sexual partners should be informed and treated as well to prevent reinfection and spread of infection. Additionally, advising the patient on the importance of consistent condom use to prevent future STIs will be an important step in her care. Hence, the correct option is A. Treatment with a course of antibiotics effective against mixed flora.