Sexually Transmitted Infections

Question 1

How might chlamydia present in women? In males? What is the treatment?

Answer 1

• Males - asymptomatic, dysuria, clear/white discharge, scrotal swelling/pain/tenderness/swelling (latter equivalent to PID)
• Women - intermenstrual bleeding, post-coital bleeding, deep dyspareunia, vaginal discharge, PID
  
  • Cervix - friable, red, mucus-y discharge
• Azithromycin (preferred) - single dose, or doxycycline (10 day course)
  
  • Contact tracing

Question 2

How might gonorrhoea present in males? In females? What is the treatment?

Answer 2

• Males - dysuria (severe), purulent discharge, rectal infection, throat symptoms uncommon. Uncommonly asymptomatic
  
  • Complications - epididymitis, urethritis, stricture development
• Females
  
  • Intermenstrual bleeding, post-coital bleeding, deep dyspareunia, vaginal discharge
• Ceftriaxone IM and azithromycin PO (single doses)

Question 3

How might a woman with trichomonas present? What is the treatment?

Answer 3

• Women - vaginal/vulval inflammation, green/frothy/fishy discharge, itchiness discomfort
  
  • Cervix - strawberry appearance
• Metronidazole or tinidazole (single doses)

Question 4

What communities is syphilis most common in? What is the treatment?

Answer 4

• MSM and ATSI communities
• Benzylpenicillin IM (single dose or more if severe)