Sexual Medicine Flashcards
Syphilis causing bacteria
T. pallidum
Primary Syphilis
Painless chancre
Secondary Syphilis
Chancre heals
Rash 4-8 weeks after, widespread red macular-papular, normally not itchy
Tertiary Syphilis
Chronic end organ complications - Includes cardiovascular syphilis, neurosyphilis, and gummatous syphilis
Diagnosis of syphilis
Swab + dark field microscopy of chancre if too early for serology
Serology - VDLR, serum EIA
Lumbar puncture - evidence of neurosyphilis and ocular involvement (uveitis)
HIV - should test in everyone with syphilis
Treatment early syphilis/ contacts
IM benzylpenicillin
PO doxycycline if allergic
Treatment neurosyphilis
IV benzylpenicillin
If pen allergic –> desensitization and then give IV benpen or PO high dose doxycycline
Consider addition of prednisolone for febrile illness after starting antibx (Jarisch-Herxheimer reaction)
Gonorrhoea cause
Neisseria gonorrhoeae (gram negative diplococcus)
Gonorrhoea symptoms
Usually asymptomatic, can cause penile/ vaginal discharge
Complicated or untreated can have disseminated effect
Treatment gonorrhoea
IM ceftriaxone
Investigation gonorrhoea
Men: urinalysis/ NAAT
Women: vaginal swab NAAT
Chlamydia bacteria
Chlamydia trachomatis (gram negative)
Investigation chlamydia
NAAT
Treatment chlamydia
1st line: PO doxycycline
2nd line: azithromycin/ levofloxacin
Pregnant: 1g azithromycin STAT
Which type of herpes simplex virus causes genital herpes?
HSV-1 and HSV-2
