Sexually Transmitted Infections Flashcards
Causes of PAINLESS genital ulcers.
Primary Syphilis (Chancre) , Lymphogranuloma venereum, Granuloma inguinale
Causes of PAINFUL genital ulcers.
Herpes simplex type 2, Chancroid
Treatment/etiology of chancroid
H. ducreyi ( think ducreyi = CRY = painful )
250 mg IM ceftriaxone x 1 OR
1 gram zithromax PO x 1
Manifestations of primary syphilis .
localized, painless ulcer (chancre) at location of inoculation
Manifestation of secondary syphilis.
weeks to months after initial chancre, 25% of patients will develop rash ( mostly on palms, macular in nature), fevers, HA, malaise, and diffuse adenopathy
This severe form of secondary syphilis causes severe ulceration, usually in HIV infected patients .
Lues Maligna
A patient with documented positive RPR presents with acute, progressive visual acuity loss.
Ocular syphilis… should be considered a presentation of neurosyphilis and managed accordingly.
What is latent syphilis?
Documented T. pallidum infection via serologic testing, in the absence of any symptoms.
Difference between early and late latent syphilis….
12 month cutoff. If the disease was thought to be acquired in last 12 months ( ie sexual debut was in last 12 months) then it is considered early.
Major categorical manifestations of Late (Tertiary) Syphilis?
Three major categories:
1) CNS involvement
2) Cardiovascular
3) Gummatous
Lancinating pains and paresis are common in what STI condition?
Neurosyphilis ( tabes dorsalis specifically)
A patient with documented tertiary syphilis presenting with ocular signs such as no pupillary constriction to light, intact accommodation, and meiotic pupil.
Argyll Robertson Pupil
Tx of late syphilis (gummatamous or cardiovascular ).
2.4 million units Penicillin G IM q weekly
Alternative for treatment of syphilis in PCN allergic patient?
Doxycycline
Tx for Granuloma inguinale.
Doxycycline 100 mg bid x 3 weeks, or zithromax 1 g q week
