Genital Tract Infection + STD Flashcards
What are the main types of STIs?
- Genital Herpes
- Syphyllis
- N. Gonorrhoea
- Chlamydia Trachomatis
What organism causes Syphilis and what is its incubation period?
- Caused by Spirochaete Treponema Pallidum
- Incubation period of 9-90 days
What are the 3 states of Syphilis?
=> Primary stage
- Chancre (painless ulcers at the site of sexual contact)
- Local non-tender lymphadenopathy
- Not seen in women
=> Secondary stage (occurs 6-10 weeks after primary stage)
- Fever, lymphadenoapthy
- Rash on trunk, palms and soles
- Buccal ulcers
- Condylomata lata (painless watery lesions on the genitalia)
=> Tertiary stage
- Gummas
- Ascending aortic aneurysms
- General paralysis
- Tobes dorsalis
- Argyll-Robertson Pupil
What are the features of congenital Syphilis?
- Blunted upper incisor teeth
- Rhagadis
- Keratitis
- Saber shins
- Saddle nose
- Deafness
What are the investigations in suspected Syphilis?
=> Cardiolipin test - infection leads to production of non specific antibodies that react to cardiolipin
- Becomes -ve after treatment
- VDRL and RPR
=> Treponemal specific antibody test
- Remains +ve after treatment
- TPHA
What is the management of Syphilis?
First line: IM Benzathine Penecillin
Alternative: Doxycycline
Erythromycin/ Azithromycin is cases of penicillin allergy
Endotoxins released at the bacterial death may cause some presentation of symptoms post treatment
What is the cause of Gonorrhoea and its incubation period?
- Caused by gram -ve diplococcus Neisseria Gonorrhoea
- Acute infection can occur on any mucosal surface
- Typically GU but can be rectum or pharynx
- Incubation period of 2-5 days
What are the clinical features of Gonorrhoea?
=> Males
- Urethral discharge
- Dysuria
=> Females:
- Cervicitis
- Vaginal discharge (green and purulent)
=> Rectal and pharyngeal infection is asymptomatic
What are the complications of Gonorrhoea?
- Urethral strictures
- Epididymitis
- Salpingitis => inflammation of the fallopian tubes
What is the management of Gonorrhoea?
- IM Ceftriaxome
- If Ceftriaxome is refused, then PO Cefexime + PO Azithromycin
In cases of sensitivities to Ceftriaxome, Ciprofloxacin is given
What is Chlamydia and its incubation period?
- The most prevalent STI in the UK
- Caused by Chlamydia Trachomatis
- Incubation period of 7-21 days
What are the clinical features of Chlamydia?
- Asymptomatic in most cases
- Women => cervicitis, dysuria
- Men => urethral discharge, dysuria
What are the potential complications of Chlamydia?
- Epididymitis
- Pelvic inflammatory disease
- Endometeriosis
- Increased chance of ectopic pregnancies
- Infertility
- Reactive arthritis
- Perihepatitis
What are the investigations in suspected Chlamydia?
NAATs are the investigation of choice
In women => vulvovaginal swabs
In men => urine test
Testing should be carried out 2 weeks after potential exposure
What is the management of Chlamydia?
- Doxycycline (7 day course)
- Azithromycin (single dose)
Azithromycin preferred
- For men with urethral discharge, all partners since and 4 weeks prior to symptoms are notified
- For women and asymptomatic men, all partners over the 6 months should be notified
