Common Genital Symptom Syndromes Flashcards
What are the most common presenting complaints for genital symptoms?
Discharge Pain Rashes Lumps/swellings Sores/ulcers Itching Change in appearance "things not right"
What are the likely causes of genital symptoms?
STD
Other microbial problem
Non-microbial problem
Which microbial conditions are not regarded as STDs
Vulvovaginal candidosis Bacterial vaginosis Balanoposthitis – anaerobic/candidal Tinea cruris Erythrasma Infected sebaceous glands Impetigo Cellulitis
What is the most common pathogen in Vulvovaginal candidosis?
90% Candida albicans
Candida galbrata
Where is C. albicans most commonly acquired from?
Bowel
What are the symptoms of thrush?
Itch Discharge (thick, 'cottage cheese')
What are the risk factors for C. albicans infection?
Diabetes Oral steroids Immunosuppression Pregnancy Reproductive age group
How is Candidosis diagnosed?
History Fissuring Erythema with satellite lesions Characteristic discharge Gram staining Culture
How is Candidosis treated?
Azole antifungals Maintain skin (avoid irritants)
Which antifungals are used in Candidosis?
Clotrimazole 500mg PV once
Fluconazole 150mg PO once
What is the most common cause of vaginal discharge?
Bacterial Vaginosis
What are the symptoms of Bacterial vaginosis?
50% asymptomatic
Watery/yellow fishy discharge
May be worse post-period or sex
Sometimes itch/sore
What is the cause of bacteria vaginosis?
IMBALANCE of bacteria
Biofilm
What is the bacterial imbalance seen in bacterial vaginosis?
Increased: - Gardnerella - Ureaplasma - Mycoplasma - Anaerobes Reduced: - Lactobacilli Associated with Vit D deficiency in black women
What problems are associated with bacterial vaginosis?
Endometriosis if instrumentation associated
Premature labour
Increased risk of HIV acquision
How is Bacterial vaginosis diagnosed?
History
Thin homogenous discharge
Gram staining of vaginal discharge
How is bacterial vaginosis treated?
Metronidazole
Clindamycin
What is Zoon’s/Plasma cell balanitis?
Chronic inflammation secondary to overgrowth of commensal organisms
What are the causative bacteria of impetigo?
Staph aureus
Strep pyogenes
What are the causative bacteria of erysipelas?
Strep pyogenes
What are the causative bacteria of dermatophyte?
Trichophyton rubrum
What should be questioned if nil found on examination/test results?
Regretted sexual encounter Problems in life Mental health When did they notice problem? When were things last normal?
How should you manage a patient if nil found on examination/test results?
Acknowledge the perception
What do they suspect?
Reassure
Discuss limitations of a medical approach
