Common Genital Symptom Syndromes and Their Non-STI Causes

Question 1

What are the common presenting complaints for genetic symptomss?

Answer 1

Discharge, pain, rashes, lumps and swellings, cuts, sores, ulcers, itching, changes in appearance and a vague sense of things not being right

Question 2

Which microbial conditions are not regarded as STDs?

Answer 2

Vulvovaginal candidosis, bacterial vaginosis, balnoposthitis, tinea cruris, erythrasma, infected sebaceous glands, impetigo and cellulitis

Question 3

What are the features of vulvovaginal candidosis?

Answer 3

• Mainly candida albicans but can be C. glabrata
• Usually acquired from the bowel
• Often asymptomatic
• Symptoms: itch and discharge
• Predisposing factors: diabetes, oral steroids, immunosuppression, pregnancy and reproductive age group
• Exam: fissuring, erythema with satellite lesions and characteristic discharge

Question 4

What is the treatment of vulvovaginal candidosis?

Answer 4

Azole antifungals: clotrimazole or fluconazole

Maintain skin

Question 5

What are the features of bacterial vaginosis?

Answer 5

• Asymp. in 50%
• Watery grey/yellow fishy discharge
• May be worse after period/sex
• May be sore/itchy
• Biofilm: Increased Gardnerella vaginalis, enterococcus faecalis and actinomyces neuii and reduced lactobacilli

Question 6

What are the problems with bacterial vaginosis?

Answer 6

Associated with endometritis if uterine instrumentation/delivery, associated with premature labour and increased risk of HIV acquisition

Question 7

How is bacterial vaginosis diagnosed?

Answer 7

Thin homogenous discharge on exam, pH and gram stain smear of the discharge

Question 8

What is the treatment of bacterial vaginosis?

Answer 8

• Metronidazole or clindamycin
• Probiotics
• Vaginal acidification

Question 9

What is Zoon’s balanitis?

Answer 9

Chronic inflamm. secondary to overgrowth of commensal organisms plus foreskin malfunction

Question 10

Which organisms are responsible for impetigo?

Answer 10

Staph aureus or strep pyogenes

Question 11

Which organism is responsible for erysipelas?

Answer 11

Strep pyogenes

Question 12

Name one of the organisms that causes dermatophyte infection?

Answer 12

Trichophyton rubrum

Question 13

Which organisms are responsible for tinea cruris?

Answer 13

Dermatophytes (athlete’s groin)

Question 14

Which organism is responsible for erythrasma?

Answer 14

Corynebacterium minutissimum

Question 15

What is vestibulodynia?

Answer 15

Provoked introital tenderness

Question 16

What is vulvodynia?

Answer 16

Persistent burning or aching