Sexually Transmitted Infections Flashcards
Causes of discharge
Gonorrhoea
Chlamydia
Trichomonas
Candida
BV
Causes of ulceration
Syphillis - no pain
HSV - pain
LGV (chlamydia)
Chancroid (G- Haemophilus ducreyi)
Donovanosis (Klebsiella granulomatis)
Causes of rashes, lumps
Genital warts - HPV
Molluscum contagiosum
Scabies
Pubic lice
Causes of discharge
Gonorrhoea
Chlamydia
Trichomonas
Candida
BV
Neisseria gonorrhoeae micro description
Obligate intracellular gram -ve diplococcus
Most common STI in Europe
Gonococcal urethritis
Neonatal complication of gonorrhoea
Opthalmica neonatorum - neonatal conjunctivitis
Gonorrhoea Ix
Urethral/rectal smears and culture - GS
Gonorrhoea Mx
250 mg ceftriaxone
Chlamydia micro description
Obligate intracellular gram -ve pathogen, can’t be cultured on agar
Chlamydia Serovars
A-C - trachoma
D-K - genital chlamydia, opthalmica neonatorum
Chlamydia Dx
NAAT from genital swabs
Chlamydia Mx
azithromycin 1g stat
OR
doxycycline 100mg BD 7d
Chlamydia complications
PID → infertility
Epididymitis
Reiter’s syndrome - triad of conjunctivitis, reactivitis and urethritis
Eyes - conjunctivitis, opthalmica neonatorum
LGV what is it
Lymphatic infection with Chlamydia serovars L1, L2, L3
LGV progression
- 1ary genital inflammation 3-12 days
- 2ary 2wks - 6mths inguinal buboes + flu-like illness
- Late - inguinal lymphadenopathy, genital elephantiasis
LGV Ix
NAAT - genotypic identification of L1/L2/L3 serovars
LGV Mx
Doxycycline 100mg BD 3 weeks
Syphillis organism name and micro description
Treponema pallidum
Obligate gram negative spirochaete
Primary Syphillis presentation
1-12 weeks post transmissions
macule → papule → painless ulcer → chancre
regional adenopathy
Secondary Syphillis presentation
Systemic presentation
Disseminated rash
Genital warts
Mucosal lesions, uveitis
Neuro involvement
Tertiary Syphillis presentation
3 syndromes
1. Gummatous
2. Cardiovascular
3. Neuro
Gummatous Syphillis presentation
Skin/bone/mucosa
Scanty spirochaetes
Cardiovascular Syphillis presentation
Aortic root dilatation / aortitis
Spirochaetes & inflammation +++
Syphyllis Dx
1ary - dark-ground microscopy
Non-treponemal antibody tests - false +ves
Treponemal antibody tests
Syphillis treatment
1x IM BenPen - Doxy if allergic
Syphillis treatment monitoring
Rapid plasma reagin (RPR) - 4x reduction to consider Tx successful
Jarisch-Herxheimer - flu/syphillis-like illness within hours, clears in 24 hrs
Summarise chancroid
Haemophilus ducreyi
Gram -ve coccobacillus
multiple painful ulcers
Dx - culture on chocolate agar and PCR
Summarise Donavanosis
Klebsiella granulomatis
Gram -ve coccobacillus
Large, beefy red ulcers
Dx - Giemsa stain - Donovan bodies
Mx - azithromycin
Summarise Trichomoniasis
Gram negative flagellated protozoa
Men - asymptomatic, urethritis
Women - discharge, strawberry cervix
Dx - wet prep micro, PCR
Mx - metronidazole
Associated with increased risk of HIV infection
Summarise BV
Abnormal vaginal flora, decreased lactobacilli
Discharge, odour
Dx - microscopy with gram stain, clue cells, raised pH
Mx - water washing, PO/topical metronidazole
Summarise Candidiasis
Thick, white cottage cheese discharge
Candida albicans
NOT STI
Mx - Oral fluconazole / topical clotrimazole
Summarise Molluscum contagiosum
Pox virus, dsDNA
papules with central punctum
Children - hands and feet, skin to skin contact
Adults - genitals, sexual contact
immunosuppressed/HIV - widespread
Usually no treatment necessary, cryotherapy if persistent/extensive
Summarise genital warts
dsDNA HPV 6 and 11
Appearance - papular, planar, pedunculated, pigmented, carpet, keratinised
Home - Podophyllotoxin
Clinic - cryotherapy , 2nd - Imiquimod
Viral STIs
Hepatitis
HSV
HIV
Monkeypox - lesions → scabs, Tecovirimat can be used
