Sexually transmitted disease Flashcards
Describe the things to think about when taking a sexual history
Cause of genital warts?
HPV 6, 11
Treatment for genital warts?
- Topical podophyllin
- Imiquimod
- Ablation
Name some causes of genital ulcers?
- Genital herpes
- Syphilis
- Lymphogranuloma venerum
- Tropical infections
Describe Genital herpes?
- Herpes simplex virus
- Flu-like prodrome, then vesicles/papules around genitals, anus, throat
- They burse, forming painful shallow ulcers
- Also urethral discharge, dysuria, urinary retention, proctatitis
Describe the diagnosis and treatment of genital herpes?
- Diagnosis
- Viral PCR (vesicle fluid)
- Treatment:
- Analgesia
- Topical lidocaine
- Aciclovir, valaciclovir, famciclovir
Cause of syphilis?
Treponema pallidum
Describe the presentation of syphilis?
- Primary
- Within 90days of infection.
- Macule->papule->painless ulcer (chancre). Central slough, defined rolled edge
- Highly infectious
- Secondary
- Dissemination within 4-10 weeks after chancre
- Maculopapular, flexor rash, mucous patches, fever, lymphadenopathy
- Tertiary
- 20-40 years after infection
- Neurosyphilis, gummatous syphilis
Describe Neurosyphilis?
- Aseptic meningitis
- Focal neurological defects
- Argyll robtertson pupil
- Tabes dorsalis (areflexia, extensor plantar reflex, charcot joints)
Describe the defect here?
- Argyll Robertson pupil
Describe gummatous syphilis?
Destructive granuloma in skin, mucous membranes and viscera
What effects can tertiary syphilis have on the cardiovascular system?
- Aortitis
- Aortic regurgitation
Describe the diagnosis of syphilis?
- PCR
- Serology
Describe the treatment for syphilis?
- Parenteral ben pen
- Boosted with probenicid in CSF disease
Describe a reaction which can occur during syphilis treatment?
- Jarisch-Herxheimer reaction
- fever, rash, tachycardia after first dose of antibiotic
- due to the release of endotoxins following bacterial death
- no treatment other than antipyretics
Describe Lymphogranuloma venerum?
- Caused by chlamydia trachomatis
- MSM in UK
- Painless papule/ulcer -> lymphadenopathy, arthralgia, fever, pneumonitis
- Direct transmission to rectal mucosa causes haemorrhagic proctitis, rectal bleeding
Diagnosis and treatment of Lymphogranuloma venerum?
- Diagnosis
- PCR
- Treatment
- Doxycycline
Name 2 tropical STIs?
- Chancroid (haemophilis ducreyi)
- Donovanosis (klebsiella granulomatis)
Describe the tropical sexually transmitted infections?
- Both cause genital ulceration and lymphadenitis
- Spread of infection into overlying tissue (pseudobobo)
- Diagnosis: H. ducreyi PCR, donovan bodies in tissue
- Treatment: Azithromycin, ceftriaxone
Overview of urethritis and vaginal discharge
