STIs

Question 1

syphilis

Answer 1

inoculation -> disease manifestation 0-3 months
cause: treponema
dx: dark field microscopy (1 syph), nontreponemal test (1/2/3 syphilis; VDRL and RPR) and treponemal test (confirms nontreponemal in 1/2/3; FTA-ABS and MHA-TP and FTA-ABS-19S-IgM Or SPHA/IgM-capature ELISA for congenital syphilis)
sx: primary - chancre, secondary - diffuse skin eruption, condyloma lata, perleche, moth eaten alopecia, tertiary - gumma, cardiac, neuro issues, congenital - hutchinson’s triad (deafness, keratitis, teeth)
Tx: penicillin (if allergic, then doxycycline)

Question 2

chancroid

Answer 2

inoculation -> disease manifestation < 1 week

cause: hemophilus ducreyi
dx: culture
sx: painful undermined ulcers +/- LAD
tx: azithromycin

**SEEN IN PROSTITUTES

Question 3

gonorrhea

Answer 3

inoculation -> disease manifestation < 1 week

cause: neisseria gonorrhea
dx: culture (requires iron to grow)
sx: often no skin lesions, but may have arthritis + hemorrhagic acral pustules
tx: azithromycin + ceftriaxone

Question 4

lymphogranuloma venereum

Answer 4

inoculation -> disease manifestation < 1 week

cause: chlamydia trachomatis serovars L1-3
dx: culture
sx: 3 stages involving (a) transient painless ulcer +/- lymphangitis (b) buboes +/- LAD (c) proctocolitis
tx: doxycycline

Question 5

granuloma inguinale “donovanosis”

Answer 5

inoculation -> disease manifestation 2-12 weeks

cause: klebsiella
dx: Donovan bodies (better seen on stain than pathology; organisms on the inside of phagocyte’s cytoplasm)
sx: painless, beefy red, friable ulcers +/- LAD
tx: azithromycin