Sexually Transmitted Infections Flashcards
What are the health effects of STIs spreading throughout the population?
- Decreased fertility rate
- Neonatal impact (congenital syphilis)
- Increased healthcare burden
What are the public health principles of STI management?
- Prevention (HPV vaccination, education, easy access to barrier protection)
- Screening (easy access to screening, partner testing where applicable)
- Prompt treatment where applicable
Which groups are at highest risk of gonorrhoea?
- MSM
- ATSI
- Overseas travellers
Aetiology/pathophysiology of gonorrhoea
- Gram negative bacteria
- Infects columnar and cuboidal epithelium (not squamous in adults)
How does gonorrhoea spread? Specifically, which surfaces?
- Transmitted through infected secretions from one mucus membrane to another
- Spread through penile, vaginal, oral, or anal contact
Incubation period of gonorrhoea in men vs women
- Men: 2-5 days
- Women: 5-10 days
Clinical features of gonorrhoea in men
- Painful urination, discharge, urethral discomfort
- Testicular pain
- Anal pain/bleeding/discharge
Clinical features of gonorrhoea in women
- Cervical discharge (presenting as vaginal)
- Post-coital/intermenstrual bleeding
- PID (lower abdo pain, deep dyspareunia, fever)
- Rectal infection
- Bartholin’s abscesses
Clinical features of gonorrhoea in neonates
Conjunctivitis (sight-threatening)
How is gonorrhoea diagnosed?
- Microscopy of urethral/cervical/rectal smears
- Culture
- NAAT (nucleotide amplification, like PCR)
Gonorrhoea treatment
- Varies by local guidelines. Firstline antibiotics are ceftriaxone and azithromycin; second line gent instead of ceftriaxone
- Avoid sex for a week
- Partner notification/treatment
- Test of cure; screen for other bloodborne diseases (HIV, Hep B/C)
Which age group are at most risk of chlamydia?
15-24 years.
Please describe aetiology/transmission/incubation period of chlamydia
- Gram negative bacteria
- Primarily transmitted through penetrative sex (body fluids)
- Incubation period is 1-3 weeks
Clinical features of chlamydia in men
- Urethral discharge, dysuria
- Testicular pain
- Rectal infection (bleeding/discharge)
- Conjunctivitis/reactive arthritis
Clinical features of chlamydia in women
- Post-coital bleeding, vaginal (cervical) discharge
- PID
- Rectal infection
- Conjunctivitis
- Reactive arthritis
- Bartholin’s abscesses
Clinical features of chlamydia in neonate
- Conjunctivitis
- Otitis media
- Pneumonia
Fertility-related sequelae of chalmydia
- 10-40% cases lead to PID
- Of those, up to 20% can become infertile
- Tubal factor infertility, ectopic pregnancy, chronic pelvic pain
Chlamydia diagnosis
- NAAT
- Sample comes from first-pass urine/mucosal swab (men: rectla, proximal urethral, ete; women: rectal, endo-cervical, self-collected vaginal)
Chlamydia treatment
- Doxycycline 1 week (or 2 weeks complicated)
- Partner notification (last 6 months) AND treatment
- Notify health department
- No sex for a wek 1
Which STI does not have a cell wall? How is this disease transmitted?
- Mycoplasma genitalium (bane of sex doctor’s life)
- Transmitted through mucosal contact
(Which antibiotic class can’t we use against this if it doesn’t have a cell wall?)
Clinical features of mycoplasma genitalium are similar to…
Ghonorrhoea and chlamydia
Diagnosis of mycoplasma genitalium in men vs women
- Men: first pass urine/rectal swab NAAT
- Women: endocervical swab, high vaginal swab/first pass uirine NAAT
First line treatment + other precautions for mycoplasma genitalium
- Doxycycline followed by azithromycin
- Partner notification
- Test of cure
Which groups are at higher risk for syphilis?
- MSM
- Indigenous people
- Overseas population living in Australia
