"I would not start clindamycin. We don't know if the doxy is helping and there is no evidence that she has an infection. That said it won't hurt to use it empirically for another 6 weeks.
An abdominal ultrasound is necessary to ruleout an abdominal mass that could be causing her nosebleeds. If she starts bleeding profusely again the first test that people will want to look at is an abdominal ultrasound. It is one of the only tests that she has not had. It is noninvasive and fairly stress free."
