Sexually Transmitted Infections Flashcards
List 5 infections commonly transmitted via anilingus
Amoeba Cryptosporidia Giardia Shigella HAV
What kind bacteria is gonorrhoea?
Gram negative diplococci
What is the incubation period of gonorrhoea?
2-7 days
What is the most common presentation of gonorrhoea in females?
Asymptomatic
What is the most common presentation of gonorrhoea in females?
Urethritis with thick, creamy urethral discharge (can block urethra and cause pain)
What other kinds of presentations can be caused by gonorrhoea besides urethritis?
Oral sex involving transmission of gonorrhoea can result in pharyngitis and lymphadenopathy
What are some of the symptoms of gonorrhoea dissemination?
Arthritis Maculopapular rash Meningitis Endocarditis Epididymitis Peri-hepatitis
What STIs can cause PID?
Gonorrhoea
Chlamydia
Mycoplasma genitalium
What is neonatal gonococcal opthalmia?
Gross purulent conjunctivitis in 1st week of life
Can cause perforation and blindness by days 2-5
How is neonatal gonococcal opthalmia treated?
IV cefotaxime for a week
Also irrigate eyes regularly
What diagnostic specimens are taken in a case of suspected gonorrhoea?
Cervical swab into charcoal transport
Male urethral swabs
Urine
Others (conjunctiva, pharyx, skin lesions, anal, CSF, blood, synovial fluid)
What laboratory investigations are used for gonorrhoea?
Non-selective CBA in CO2
Selective Thayer-Martin agar
Culture for antibiotic sensitivities
What is the most common diagnostic method used for gonorrhoea and chlamydia?
NAAT from genital swabs or first void urine
What is the disadvantage of NAAT for gonorrhoea?
May have cross reaction with mucosal commensal Neisseria spp.
What other infection is gonorrhoea especially associated with?
Chlamydia (~50% of cases)
How is gonorrhoea treated?
Ceftriaxone IM/IV AND azithromycin orally
Does gonorrhoea show increasing antibiotic resistance?
Yes
What kind of organism is chlamydia?
Obligate IC parasite
What kind of epithelium do chlamydia and gonorrhoea like to infect?
Columnar
Which serovars of chlamydia cause genital infection?
D-K
What symptoms does chlamydia cause in females and males?
Females: cervicitis, endometritis, vaginal discharge, urethritis, dysuria, irregular bleeding, pelvic pain
Males: urethritis with clear urethral discharge, dysuria, meatal erythema, testicular pain, prostatitis
BUT frequently asymptomatic for both
Which serovars of chlamydia cause lymphogranuloma venereum?
L 1-3
What is LGV?
Invasive lymphatic infection causing suppurative lymphadenopathy
Can cause procto-colitis with strictures in MSM
What syndromes can neonatal chlamydia infection cause?
Conjunctivitis (25%)
Pneumonia (10%)
Is culture performed routinely for chlamydia?
No
When is test of cure required for chlamydia?
Post procedure
Pregnancy
Performed 4-6 months post-treatment
How is chlamydia treated?
Azithromycin orally (IV if severe PID) OR doxycycline orally (avoid in pregnancy)
What kind of organism is trichomonas vaginalis?
Flagellated protozoan
What symptoms does trichomonas commonly produce?
Often asymptomatic
Can present with frothy, green-yellow discharge
Cervical erythyma and friability
Pruritis, dysuria and abdominal pain
What does trichomonas increase the risk of?
HIV transmission
What laboratory testing is performed for trichomonas?
High Vaginal Swab (HVS; “wet prep” microscopy or culture)
Urine (for PCR)
Sometimes seen on Pap smear
How is chlamydia treated?
Metronidazole or tinidazole orally
Clindamycin cream
What is treponema pallidum infection called?
Syphilis
What methods of laboratory detection are used for syphilis?
Microscopy
Serology
What are non-treponemal serological tests? When are they used?
Ab to cellular lipids and lecithin (e.g. VDRL, RPR)
Useful for screening and monitoring therapy (positive 4-8 weeks post-infection)
What may cause FPs in non-treponemal tests?
CT disorders, viral infections, IVDU, pregnancy
What are treponemal tests? When are they positive?
E.g. EIA, TPHA, TPPA, FTA-Abs
Positive slightly earlier than non-treponemal and remain positive for life
How is mycoplasma genitalium diagnosed?
NAAT
Is mycoplasma genitalium antibiotic resistant?
Yes
What symptoms does mycoplasma genitalium cause?
Urethritis in men
Cervicitis and acute endometritis in women
What infections may predispose to HIV transmission?
Trichomonas vaginalis
Mycoplasma genitalium
How is mycoplasma genitalium treated?
Azithromycin
Moxifloxacin (but expensive)
